Organization
FOUNTAIN RESOURCES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. CAROLYN KATZIN MS, CNS (PRESIDENT)
(310) 766-8597
Entity
Organization
Contact information
Practice address
8900 WILSHIRE BLVD, BEVERLY HILLS, CA 90211-1958
(310) 208-0708
Mailing address
12011 SAN VICENTE BLVD STE 402, LOS ANGELES, CA 90049-4946
(310) 766-8597
Taxonomy
Speciality
Code
Description
License number
State
133N00000X
Nutritionist
Primary
005347
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1205947421
INDIVIDUAL NPI
CA
Enumeration date
10/07/2009
Last updated
03/10/2021
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