Organization
REGENESIS NUTRITION A MEDICAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. VICTOR GERMAN TAMASHIRO (PRESIDENT)
(818) 515-6598
Entity
Organization
Contact information
Practice address
4333 ADMIRALTY WAY UNIT 3, MARINA DEL REY, CA 90292-5469
(818) 515-6598
Mailing address
4333 ADMIRALTY WAY UNIT 3, MARINA DEL REY, CA 90292-5469
(818) 515-6598
Taxonomy
Speciality
Code
Description
License number
State
133VN1006X
Metabolic Nutrition Registered Dietitian
Primary
—
—
174200000X
Meals Provider
Primary
—
—
Other
Enumeration date
03/12/2026
Last updated
03/18/2026
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