Healthcare Provider Details

I. General information

NPI: 1497982888
Provider Name (Legal Business Name): NATALIE D. MUTH M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/12/2009
Last Update Date: 05/23/2026
Certification Date: 05/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

374 N COAST HIGHWAY 101 STE 180
ENCINITAS CA
92024-2542
US

IV. Provider business mailing address

374 N COAST HIGHWAY 101
ENCINITAS CA
92024-2542
US

V. Phone/Fax

Practice location:
  • Phone: 619-432-2368
  • Fax:
Mailing address:
  • Phone: 619-432-2368
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080B0002X
TaxonomyPediatric Obesity Medicine Physician
License NumberA116344
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: