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General NPI Number Information
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NPI Number | 1912704313
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Entity Type | Organization
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Legal Business Name | CLINICAL DIETITIAN SOLUTIONS, LLC
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Dates
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Enumeration Date | 02/25/2025
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Last Update Date | 03/11/2026
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Provider Practice Location Address
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Address Line | 2960 HUNTINGTON DR # 80813
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City | SAN MARINO
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State | CA
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Zip | 91108-2237
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Country | US
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Telephone | 626-416-8895
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Fax |
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Provider Business Mailing Address
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Address Line | 2960 HUNTINGTON DR # 80813
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City | SAN MARINO
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State | CA
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Zip | 91108-2237
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Country | US
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Telephone | 626-620-1908
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Fax |
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Authorized Official
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Title or Position | MANAGING PARTNER
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Name | MRS. MARIA RODELITA DEYPALAN ODONO
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Credential | RDN, MS
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Telephone | 626-416-8895
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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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