Provider Demographics
NPI:1104677764
Name:ALHAMBRA NUTRITION LLC
Entity type:Organization
Organization Name:ALHAMBRA NUTRITION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JUAN CARLO
Authorized Official - Middle Name:
Authorized Official - Last Name:ALHAMBRA
Authorized Official - Suffix:
Authorized Official - Credentials:RDN
Authorized Official - Phone:408-337-2280
Mailing Address - Street 1:1025 53RD ST
Mailing Address - Street 2:
Mailing Address - City:EMERYVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:94608-3101
Mailing Address - Country:US
Mailing Address - Phone:408-337-2280
Mailing Address - Fax:510-495-1116
Practice Address - Street 1:1025 53RD ST
Practice Address - Street 2:
Practice Address - City:EMERYVILLE
Practice Address - State:CA
Practice Address - Zip Code:94608
Practice Address - Country:US
Practice Address - Phone:408-337-2280
Practice Address - Fax:510-495-1116
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-01
Last Update Date:2024-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty