Active NPI
Moav Paolina Avital, MS, RD
- Registered Dietitian
- Los Angeles, CA
National Provider Identifier
1104163039
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 1086079
- Practice address
- 1746 N Gramercy PL Apt 14
Los Angeles, CA 90028-5818 - Phone
- (323) 717-5857
- NPI assigned
- Jan 11, 2013
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 1086079 | CA | Primary |
Addresses
Primary practice location
1746 N Gramercy PL Apt 14
Los Angeles, CA 90028-5818
Mailing address
1746 N Gramercy PL Apt 14
Los Angeles, CA 90028-5818
Phone (323) 717-5857
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1086079 | CA | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1357862400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1357862400000",
"number": "1104163039",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1746 N GRAMERCY PL APT 14",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900285818",
"telephone_number": "323-717-5857"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1746 N GRAMERCY PL APT 14",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900285818",
"telephone_number": "323-717-5857"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AVITAL",
"first_name": "MOAV",
"middle_name": "PAOLINA",
"credential": "MS, RD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-01-11",
"last_updated": "2013-01-11",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "CA",
"license": "1086079",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.