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General NPI Number Information
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NPI Number | 1356031926
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Entity Type | Organization
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Legal Business Name | ISABELLA GALLARDO NUTRITION LLC
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Dates
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Enumeration Date | 05/08/2023
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Last Update Date | 07/28/2023
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Provider Practice Location Address
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Address Line | 482 W SAN YSIDRO BLVD # 1514
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City | SAN DIEGO
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State | CA
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Zip | 92173-2444
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Country | US
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Telephone | --
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Fax |
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Provider Business Mailing Address
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Address Line | 482 W SAN YSIDRO BLVD # 1514
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City | SAN DIEGO
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State | CA
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Zip | 92173-2444
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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 | OWNER, REGISTERED DIETITIAN
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Name | ISABELLA GALLARDO
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Credential | MS, RDN
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Telephone | 619-496-4132
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 133NN1002X
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Taxonomy Name | Nutrition Education Nutritionist
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License Number |
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License Number State |
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Taxonomy #2
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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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