Healthcare Provider Details

I. General information

NPI: 1134206337
Provider Name (Legal Business Name): PAULA M PARTCH R.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: PAULA BASSI

II. Dates (important events)

Enumeration Date: 11/01/2006
Last Update Date: 01/25/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2212 E 4TH ST
SANTA ANA CA
92705-3870
US

IV. Provider business mailing address

2212 E 4TH ST
SANTA ANA CA
92705-3870
US

V. Phone/Fax

Practice location:
  • Phone: 714-628-3242
  • Fax: 714-744-0136
Mailing address:
  • Phone: 714-628-3242
  • Fax: 714-744-0136

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number402905
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: