Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NN1001X | Nutrition | DC26660 | CA |
NPI | 1437426285 |
---|---|
Provider Name | Dr. Randy Talai |
First Address | Los Angeles, CA 90010-1577 |
Second Address | Los Angeles, CA 90010-1577 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/11/2011 |
Last Update Date | 25/04/2012 |