Organization
BAMBOO NUTRITION THERAPY, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LISA MONARREZ (DIRECTOR/INTAKE MANAGER)
(323) 391-7262
Entity
Organization
Contact information
Practice address
619 S OLIVE ST STE 403, LOS ANGELES, CA 90014-1546
(323) 391-7262
Mailing address
PO BOX 298, SAN JUAN CAPISTRANO, CA 92693-0298
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
—
Other
Enumeration date
06/30/2018
Last updated
01/30/2025
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