Total Nutrition Therapy Inc

Primary specialty

Parenteral & Enteral Nutrition Supplies (DME)Taxonomy code 332BP3500X

Legal business name

TOTAL NUTRITION THERAPY INC

Practice address

16644 E. Johnson Dr. Suite B
City of Industry, CA 91745-2412

Phone

(714) 777-8794

Fax

(714) 777-8773

NPI assigned

Apr 11, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Bentzion Mandelbaum

Title

President

Phone

(626) 820-7411

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

Locations

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

{
    "created_epoch": "1176249600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1740403054",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16644 E. JOHNSON DR. SUITE B",
            "city": "CITY OF INDUSTRY",
            "state": "CA",
            "postal_code": "917452412",
            "telephone_number": "714-777-8794",
            "fax_number": "714-777-8773"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16644 E. JOHNSON DR. SUITE B",
            "city": "CITY OF INDUSTRY",
            "state": "CA",
            "postal_code": "917452412",
            "telephone_number": "714-777-8794",
            "fax_number": "714-777-8773"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TOTAL NUTRITION THERAPY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-11",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "MANDELBAUM",
        "authorized_official_first_name": "BENTZION",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "626-820-7411",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332BP3500X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "DME03062F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Parenteral & Enteral Nutrition Supplies (DME) in City of Industry, CA
• Providers in City of Industry, CA by specialty
• Parenteral & Enteral Nutrition Supplies (DME) in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.