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NPI Code Detail

MEDICARE: VANESSA AVILA R.D.

MEDICARE: VANESSA AVILA R.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1133V00000XRegistered Dietitian86021194CA

General Provider Information

NPI Number : 1023550324
Entity Type Code : Individual
Provider Name (Legal Business Name) : VANESSA AVILA R.D.
Provider Business Mailing Address
First Line : 5831 RAMON CT
Second Line :
City : COMMERCE
State : CA
Zip : 90040-3804
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 680 E COLORADO BLVD STE 180
Second Line :
City : PASADENA
State : CA
Zip : 91101-6144
Country : US
Telephone Number : 626-648-5315
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/17/2016
Last Update Date : 07/13/2024

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Directions to “ VANESSA AVILA R.D.” Practice Location

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