Organization
NUTRITION CARE PLUS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LEYLA KAVUSI DAVIJANI RD (PRESIDENT)
(949) 606-3573
Entity
Organization
Contact information
Practice address
26572 ROYALE DR, SAN JUAN CAPISTRANO, CA 92675-1412
(949) 429-3320
(949) 429-3302
Mailing address
26572 ROYALE DR, SAN JUAN CAPISTRANO, CA 92675-1412
(949) 429-3320
(949) 429-3302
Taxonomy
Speciality
Code
Description
License number
State
332U00000X
Home Delivered Meals
Primary
932113
CA
335G00000X
Medical Foods Supplier
932113
CA
Other
Enumeration date
10/19/2015
Last updated
10/20/2015
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