Healthcare Provider Details

I. General information

NPI: 1346664414
Provider Name (Legal Business Name): ALLISON MICHELLE ABEL RDN, CNSC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/10/2014
Last Update Date: 02/10/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4425 S CENTRAL AVE
LOS ANGELES CA
90011-3629
US

IV. Provider business mailing address

1849 N BERENDO ST #3
LOS ANGELES CA
90027-4190
US

V. Phone/Fax

Practice location:
  • Phone: 323-265-1998
  • Fax:
Mailing address:
  • Phone: 619-818-2071
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number1025092
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: