Organization
TOTAL NUTRITION THERAPY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BENTZION MANDELBAUM (PRESIDENT)
(626) 820-7411
Entity
Organization
Contact information
Practice address
16644 E. JOHNSON DR. SUITE B, CITY OF INDUSTRY, CA 91745-2412
(714) 777-8794
(714) 777-8773
Mailing address
16644 E. JOHNSON DR. SUITE B, CITY OF INDUSTRY, CA 91745-2412
(714) 777-8794
(714) 777-8773
Taxonomy
Speciality
Code
Description
License number
State
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
Primary
—
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
DME03062F
—
CA
Enumeration date
04/11/2007
Last updated
07/21/2022
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