MEDICARE: SAPNA BHALSOD MS, 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	86155777	CA

General Provider Information

NPI Number	:	1841808003
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SAPNA BHALSOD MS, RD

Provider Business Mailing Address
First Line	:	4816 W MOUNTAIN VIEW DR APT 6
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92116-1758
Country	:	US
Telephone Number	:	248-904-8339
Fax Number	:

Provider Business Practice Location Address
First Line	:	4816 W MOUNTAIN VIEW DR APT 6
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92116-1758
Country	:	US
Telephone Number	:	248-904-8339
Fax Number	:

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

Provider Enumeration Date	:	07/14/2020
Last Update Date	:	07/14/2020

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