Socal Nutritionists LLC
Dietitian, Registered in San Pedro, CA. Organization (NPI-2).
NPI number1164048757
StatusActive
Last updated in NPPESFeb 7, 2022
Details
- NPI
- 1164048757
- Entity type
- Organization (NPI-2)
- Legal business name
- Socal Nutritionists LLC
- Organization subpart
- No
- Enumeration date
- Jun 19, 2020
- Certification date
- Feb 7, 2022
- Last updated
- Feb 7, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 133V00000X | Dietitian, Registered | – | – | Yes |
| 133VN1005X | Dietitian, Registered, Nutrition, Renal | – | – | |
| 133VN1006X | Dietitian, Registered, Nutrition, Metabolic | – | – | |
| 133VN1201X | Dietitian, Registered, Nutrition, Obesity and Weight Management | – | – | |
| 133VN1501X | Dietitian, Registered, Nutrition, Sports Dietetics | – | – |
Practice location
720 W 30th StSan Pedro, CA 90731
Phone 310-395-7973
Mailing address
720 W 30th StSan Pedro, CA 90731-6616
Phone 424-280-6110
Authorized official
Saira G Torres
Ceo
4242806110
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