Organization Name: | LEPORT |
NPI Number: | 1952787061 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | ELLEN ROHAN (PRACTICE MANAGER) |
Mailing Address: | 18111 Brookhurst St Suite 5600 Fountain Valley |
State: | CA US |
Postal Code: | 927086728 |
Phone Number: | 7148614666 |
Fax Number: | 7148614674 |
NPI Enumeration Date: | 07/31/2015 |
NPI Last Update Date: | 07/31/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 133V00000X |
License Number: | 963173 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Dietary & Nutritional Service Providers |
Taxonomy Classification: | Dietitian, Registered |
Taxonomy Specialization: | |
Taxonomy Definition: | A registered dietician (RD) is a food and nutrition expert who has successfully completed a minimum of a bachelor |