MEDICARE: KRISTEN RENEE BELL RD

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	963755	CA

General Provider Information

NPI Number	:	1811484348
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KRISTEN RENEE BELL RD

Provider Business Mailing Address
First Line	:	3325 CASTLE HEIGHTS AVE APT 203
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90034-2767
Country	:	US
Telephone Number	:	310-525-9570
Fax Number	:

Provider Business Practice Location Address
First Line	:	1740 STEWART ST
Second Line	:
City	:	SANTA MONICA
State	:	CA
Zip	:	90404-4022
Country	:	US
Telephone Number	:	310-393-4647
Fax Number	:

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

Provider Enumeration Date	:	04/19/2018
Last Update Date	:	04/19/2018

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