MEDICARE: MRS. NATALIE ERIN LOMAZOV R.D. , C.D.E.

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
1	133V00000X	Registered Dietitian

General Provider Information

NPI Number	:	1326183070
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. NATALIE ERIN LOMAZOV R.D. , C.D.E.

Provider Business Mailing Address
First Line	:	13330 VIA MILAZZO UNIT 2
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92129-5144
Country	:	US
Telephone Number	:	858-243-3405
Fax Number	:	619-740-4415

Provider Business Practice Location Address
First Line	:	13330 VIA MILAZZO UNIT 2
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92129-5144
Country	:	US
Telephone Number	:	858-243-3405
Fax Number	:	619-740-4415

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/20/2007
Last Update Date	:	07/08/2007

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