Healthcare Provider Details

I. General information

NPI: 1588019384
Provider Name (Legal Business Name): SABA ARASTU RDN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/28/2016
Last Update Date: 04/28/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2110 E FLAMINGO RD STE 108
LAS VEGAS NV
89119-5191
US

IV. Provider business mailing address

2110 E FLAMINGO RD STE 108
LAS VEGAS NV
89119-5191
US

V. Phone/Fax

Practice location:
  • Phone: 702-696-9768
  • Fax:
Mailing address:
  • Phone: 702-696-9768
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number38581DI-0
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: