Provider Demographics
NPI:1285285122
Name:MARILYN MAGARAM CENTER FOR FOOD SCIENCE, NUTRITION & DIETETICS
Entity type:Organization
Organization Name:MARILYN MAGARAM CENTER FOR FOOD SCIENCE, NUTRITION & DIETETICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ANNETTE
Authorized Official - Middle Name:
Authorized Official - Last Name:BESNILIAN
Authorized Official - Suffix:
Authorized Official - Credentials:EDD, MPH, RDN
Authorized Official - Phone:818-677-4343
Mailing Address - Street 1:18111 NORDHOFF STREET
Mailing Address - Street 2:
Mailing Address - City:NORTHRIDGE
Mailing Address - State:CA
Mailing Address - Zip Code:91330
Mailing Address - Country:US
Mailing Address - Phone:818-677-3124
Mailing Address - Fax:
Practice Address - Street 1:18111 NORDHOFF STREET
Practice Address - Street 2:
Practice Address - City:NORTHRIDGE
Practice Address - State:CA
Practice Address - Zip Code:91330
Practice Address - Country:US
Practice Address - Phone:818-677-3124
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-23
Last Update Date:2019-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service