Glucosamigos PC
Dietitian, Registered in San Bernardino, CA. Organization (NPI-2).
NPI number1841972007
StatusActive
Last updated in NPPESSep 20, 2023
Details
- NPI
- 1841972007
- Entity type
- Organization (NPI-2)
- Legal business name
- Glucosamigos PC
- Organization subpart
- No
- Enumeration date
- Aug 7, 2023
- Certification date
- Sep 20, 2023
- Last updated
- Sep 20, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 133V00000X | Dietitian, Registered | – | – | Yes |
Practice location
1254 S Waterman Ave Ste 28San Bernardino, CA 92408-2857
Phone 909-763-2551 · Fax 866-475-0054
Mailing address
1254 S Waterman Ave Ste 28San Bernardino, CA 92408-2857
Phone 909-763-2551 · Fax 866-475-0054
Authorized official
Rita Heng Rubin
President
9092146301
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