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Organization
STILL I THRIVE FUNCTIONAL NUTRITION LLC
Active
Organization
STILL I THRIVE FUNCTIONAL NUTRITION LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CORAL EDELSON MS, RD (OWNER)
(781) 589-4127
Entity
Organization
Contact information
Practice address
3713 KELTON AVE, LOS ANGELES, CA 90034-7119
(781) 589-4127
Mailing address
10866 WASHINGTON BLVD # 175, CULVER CITY, CA 90232-3610
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1447896444
NPI
—
Enumeration date
02/27/2020
Last updated
04/06/2020
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