Organization
HEALTHY ME OC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TALLENE HACATORYAN RD (OWNER)
(949) 632-3118
Entity
Organization
Contact information
Practice address
4569 MACARTHUR COURT, SUITE 1100, NEWPORT BEACH, CA 92660
(949) 632-3118
Mailing address
4569 MACARTHUR COURT, SUITE 1100, NEWPORT BEACH, CA 92660
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1902313752
TYPE 1 NPI
CA
Enumeration date
10/25/2018
Last updated
10/25/2018
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