Fountain Resources, Inc.

Primary specialty

NutritionistTaxonomy code 133N00000X

License

005347 Issued in NY

Legal business name

FOUNTAIN RESOURCES, INC.

Practice address

8900 Wilshire Blvd
Beverly Hills, CA 90211-1958

Phone

(310) 208-0708

NPI assigned

Oct 7, 2009

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ms. Carolyn Katzin, MS, CNS

Title

President

Phone

(310) 766-8597

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Soheil Simzar, M.D.

  • Dermatology Physician
  • Santa Monica, CA
  • NPI 1780881797
  NPD
• Gregory S Van Dyke, MD, PHD

  • Dermatology Physician
  • Studio City, CA
  • NPI 1841328614
  NPD
• Ritu Sonia Batra, MD MPH

  • Dermatology Physician
  • Santa Monica, CA
  • NPI 1356441869
  NPD (past)
• Rene Farahmandian, PA

  • Medical Physician Assistant
  • Santa Monica, CA
  • NPI 1407176910
  NPD (past)
• Lisa Goodman, PA

  • Physician Assistant
  • Los Angeles, CA
  • NPI 1134449564
  NPD (past)
• Angelica Ibarra, PA-C

  • Medical Physician Assistant
  • Granada Hills, CA
  • NPI 1770896961
  NPD (past)
• Soheil Lahijani, MD

  • Plastic Surgery Physician
  • Los Angeles, CA
  • NPI 1992852784
  NPD (past)
• Ava T Shamban, MD

  • Dermatology Physician
  • Santa Monica, CA
  • NPI 1003922162
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1254873600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1615334400000",
    "number": "1104151273",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12011 SAN VICENTE BLVD STE 402",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900494946",
            "telephone_number": "310-766-8597"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8900 WILSHIRE BLVD",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "902111958",
            "telephone_number": "310-208-0708"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOUNTAIN RESOURCES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-10-07",
        "last_updated": "2021-03-10",
        "certification_date": "2021-03-10",
        "status": "A",
        "authorized_official_last_name": "KATZIN",
        "authorized_official_first_name": "CAROLYN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "310-766-8597",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "MS, CNS"
    },
    "taxonomies": [
        {
            "code": "133N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nutritionist",
            "state": "NY",
            "license": "005347",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL NPI",
            "identifier": "1205947421",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Fardad Forouzanpour, D.O.
• Tibor Forrai, DDS
• Fosa Medical, Inc., a Professional Corporation
• Allen Foulad, MD
• David Steven Foulad, M.D.
• David James Fournier, CRNA
• Cristina Fowler, FNP-C
• Fox Nursing and Health Services, a Professional Nursing Corporation
• Fox Nursing and Health Services, PC (Eclipse Mental Health)
• David P. Fox, PH.D.

• Nutritionist in Beverly Hills, CA
• Providers in Beverly Hills, CA by specialty
• Nutritionist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.