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General NPI Number Information
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NPI Number | 1013669928
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Entity Type | Individual
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Provider Name | CYNTHIA BANUELOS
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Gender | Female
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Dates
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Enumeration Date | 01/21/2022
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Last Update Date | 09/01/2026
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Provider Practice Location Address
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Address Line | 12200 BELLFLOWER BLVD
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City | DOWNEY
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State | CA
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Zip | 90242-2804
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Country | US
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Telephone | 562-622-4195
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Fax |
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Provider Business Mailing Address
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Address Line | 20821 SEINE AVE APT 3
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City | LAKEWOOD
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State | CA
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Zip | 90715-2811
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number |
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License Number State |
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