Healthcare Provider Details

I. General information

NPI: 1639734668
Provider Name (Legal Business Name): LAURA VAINER-MEKLER M.S
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/06/2019
Last Update Date: 06/11/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

630 L ST
CHULA VISTA CA
91911-1066
US

IV. Provider business mailing address

6075 LA JOLLA SCENIC DR S
LA JOLLA CA
92037-7851
US

V. Phone/Fax

Practice location:
  • Phone: 619-271-7100
  • Fax:
Mailing address:
  • Phone: 858-361-1305
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133NN1002X
TaxonomyNutrition Education Nutritionist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: