Provider Demographics
NPI:1033000856
Name:LUXFORD NUTRITION
Entity type:Organization
Organization Name:LUXFORD NUTRITION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:EMILY
Authorized Official - Middle Name:LUXFORD
Authorized Official - Last Name:DEFAZIO
Authorized Official - Suffix:
Authorized Official - Credentials:RD
Authorized Official - Phone:424-247-6060
Mailing Address - Street 1:1207 S GERTRUDA AVE # 90277
Mailing Address - Street 2:
Mailing Address - City:REDONDO BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90277-5125
Mailing Address - Country:US
Mailing Address - Phone:626-808-6842
Mailing Address - Fax:626-808-6842
Practice Address - Street 1:1617 S PCH HWY STE B
Practice Address - Street 2:
Practice Address - City:REDONDO BEACH
Practice Address - State:CA
Practice Address - Zip Code:90277-5612
Practice Address - Country:US
Practice Address - Phone:424-247-6060
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-07-10
Last Update Date:2025-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Multi-Specialty