Gregory Gage Wine, MSRD
Dietitian, Registered in Sacramento, CA. Individual provider (NPI-1).
NPI number1801023973
StatusActive
Last updated in NPPESJun 16, 2009
Details
- NPI
- 1801023973
- Entity type
- Individual (NPI-1)
- Name
- Mr. Gregory Gage Wine
- Credential
- MSRD
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Jun 16, 2009
- Last updated
- Jun 16, 2009
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 133V00000X | Dietitian, Registered | – | – | Yes |
Practice location
2315 Stockton BlvdSte 0102
Sacramento, CA 95817-2201
Phone 916-703-3117 · Fax 916-703-3118
Mailing address
2315 Stockton BlvdSte 0102
Sacramento, CA 95817-2201
Phone 916-703-3117 · Fax 916-703-3118
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