Active NPI
Orest V Petrishen, N.D., PH.D., C.N.C.
- Nutritionist
- Los Angeles, CA
National Provider Identifier
1932330867
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nutritionist
- License
- CNC-2372
- Practice address
- 6333 Wilshire Blvd
Ste #200
Los Angeles, CA 90048-5702 - Phone
- (323) 653-2504
- Fax
- (323) 653-2515
- NPI assigned
- Jul 27, 2009
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nutritionist | 133N00000X | CNC-2372 | IN | Primary |
| Naturopath | 175F00000X | NAT-375 | DC |
Addresses
Primary practice location
6333 Wilshire Blvd
Ste #200
Los Angeles, CA 90048-5702
Mailing address
6333 Wilshire Blvd
Ste #200
Los Angeles, CA 90048-5702
Phone (323) 382-4211
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)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CNC-2372 | IN | MD | Nutritionist |
| NAT-375 | DC | MD | Naturopath |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1248652800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1274313600000",
"number": "1932330867",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6333 WILSHIRE BLVD",
"address_2": "STE #200",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900485702",
"telephone_number": "323-382-4211",
"fax_number": "323-654-5373"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6333 WILSHIRE BLVD",
"address_2": "STE #200",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900485702",
"telephone_number": "323-653-2504",
"fax_number": "323-653-2515"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PETRISHEN",
"first_name": "OREST",
"middle_name": "V",
"name_prefix": "Dr.",
"credential": "N.D., PH.D., C.N.C.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2009-07-27",
"last_updated": "2010-05-20",
"status": "A"
},
"taxonomies": [
{
"code": "133N00000X",
"taxonomy_group": "",
"desc": "Nutritionist",
"state": "IN",
"license": "CNC-2372",
"primary": true
},
{
"code": "175F00000X",
"taxonomy_group": "",
"desc": "Naturopath",
"state": "DC",
"license": "NAT-375",
"primary": false
}
],
"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 May 20, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.