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Organization
SHARED HARVEST FOUNDATION INC
Active
Organization
SHARED HARVEST FOUNDATION INC
Active
Other names
SHARED HARVEST MYCOVIDMD
Organization subpart
No
Provider details
NPI number
Authorized official
DR. NANAEFUA AFOH-MANIN MD (CHIEF MEDICAL OFFICER)
(917) 748-3832
Entity
Organization
Contact information
Practice address
10000 WASHINGTON BLVD STE 600, CULVER CITY, CA 90232-2783
(323) 880-0121
(801) 665-5652
Mailing address
23934 DECORAH RD, DIAMOND BAR, CA 91765-1407
(917) 748-3832
Taxonomy
Speciality
Code
Description
License number
State
261QC1500X
Community Health Clinic/Center
Primary
—
NULL
Other
Enumeration date
04/14/2021
Last updated
08/04/2022
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