Healthcare Provider Details

I. General information

NPI: 1437821436
Provider Name (Legal Business Name): JULIUS SUMANG NAVARRO RDN, CSR, CNSC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/29/2021
Last Update Date: 05/23/2023
Certification Date: 05/23/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1675 SCOTT ST
SAN FRANCISCO CA
94115-3013
US

IV. Provider business mailing address

7800 EL CAMINO REAL APT 2102
COLMA CA
94014-3178
US

V. Phone/Fax

Practice location:
  • Phone: 415-353-7725
  • Fax:
Mailing address:
  • Phone: 843-304-0178
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number86006224
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code133VN1005X
TaxonomyRenal Nutrition Registered Dietitian
License Number86006224
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: