Provider Demographics
NPI:1275812380
Name:CENTER FOR DIGESTIVE HEALTH & NUTRITIONAL EXCELLENCE, INC
Entity type:Organization
Organization Name:CENTER FOR DIGESTIVE HEALTH & NUTRITIONAL EXCELLENCE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DORON
Authorized Official - Middle Name:D
Authorized Official - Last Name:KAHANA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:424-234-1840
Mailing Address - Street 1:23600 TELO AVE
Mailing Address - Street 2:SUITE #260
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90505-4035
Mailing Address - Country:US
Mailing Address - Phone:424-234-1840
Mailing Address - Fax:866-591-7297
Practice Address - Street 1:23600 TELO AVE
Practice Address - Street 2:SUITE #260
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90505-4035
Practice Address - Country:US
Practice Address - Phone:424-234-1840
Practice Address - Fax:866-591-7297
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-06
Last Update Date:2016-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA91621133N00000X, 2080P0206X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2080P0206XAllopathic & Osteopathic PhysiciansPediatricsPediatric GastroenterologyGroup - Multi-Specialty
No133N00000XDietary & Nutritional Service ProvidersNutritionistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAFK734AOtherPTAN