Provider Demographics
NPI:1285119230
Name:DOCRD L.L.C.
Entity type:Organization
Organization Name:DOCRD L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:TODD
Authorized Official - Last Name:GREENE
Authorized Official - Suffix:
Authorized Official - Credentials:EDD, MS, RDN
Authorized Official - Phone:213-700-2661
Mailing Address - Street 1:PO BOX 1138
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90078-1138
Mailing Address - Country:US
Mailing Address - Phone:213-700-2661
Mailing Address - Fax:
Practice Address - Street 1:1850 IVAR AVE
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90028-5008
Practice Address - Country:US
Practice Address - Phone:213-700-2661
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-26
Last Update Date:2021-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
No174200000XOther Service ProvidersMeals
No251E00000XAgenciesHome Health
No253Z00000XAgenciesIn Home Supportive Care
No332U00000XSuppliersHome Delivered Meals
No347C00000XTransportation ServicesPrivate Vehicle
Provider Identifiers
StateIdentifier IDID TypeIssuer
01008567OtherCOMMISSION ON DIETETIC REGISTRATION
CA1008567OtherACADEMY OF NUTRITION AND DIETETICS