Healthcare Provider Details

I. General information

NPI: 1952709933
Provider Name (Legal Business Name): GERALDINE CORNELIA ZWICKER RD CDE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: GERI CORNELIA FILET

II. Dates (important events)

Enumeration Date: 12/08/2014
Last Update Date: 12/09/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2010 ZONAL AVENUE 5E OPD
LOS ANGELES CA
90033
US

IV. Provider business mailing address

1200 NORTH STATE STREET 1 PT RM 2C2 115
LOS ANGELES CA
90033
US

V. Phone/Fax

Practice location:
  • Phone: 323-226-4556
  • Fax: 323-226-8117
Mailing address:
  • Phone: 323-409-6979
  • Fax: 323-441-8226

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: