Provider Demographics
NPI:1699461061
Name:ZOOM WEIGHT LOSS LLC
Entity type:Organization
Organization Name:ZOOM WEIGHT LOSS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:SHEILA
Authorized Official - Middle Name:
Authorized Official - Last Name:ABRISHAMY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:424-666-8547
Mailing Address - Street 1:4560 ADMIRALTY WAY STE 200
Mailing Address - Street 2:
Mailing Address - City:MARINA DEL REY
Mailing Address - State:CA
Mailing Address - Zip Code:90292-5425
Mailing Address - Country:US
Mailing Address - Phone:424-666-8547
Mailing Address - Fax:
Practice Address - Street 1:4560 ADMIRALTY WAY STE 200
Practice Address - Street 2:
Practice Address - City:MARINA DEL REY
Practice Address - State:CA
Practice Address - Zip Code:90292-5425
Practice Address - Country:US
Practice Address - Phone:424-666-8547
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-17
Last Update Date:2024-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty