Provider Demographics
NPI:1083428619
Name:NAVA LAVINE
Entity type:Organization
Organization Name:NAVA LAVINE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NAVA
Authorized Official - Middle Name:
Authorized Official - Last Name:LAVINE
Authorized Official - Suffix:
Authorized Official - Credentials:RDN
Authorized Official - Phone:310-817-1347
Mailing Address - Street 1:1812 BAGLEY AVE
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90035-4111
Mailing Address - Country:US
Mailing Address - Phone:310-817-1347
Mailing Address - Fax:424-842-7083
Practice Address - Street 1:1812 BAGLEY AVE
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90035-4111
Practice Address - Country:US
Practice Address - Phone:310-817-1347
Practice Address - Fax:424-842-7083
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-02-04
Last Update Date:2025-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Multi-Specialty