MEDICARE: MRS. FABIANA C LAHMON RD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	133V00000X	Registered Dietitian	01010197	CA

General Provider Information

NPI Number	:	1003140138
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. FABIANA C LAHMON RD

Provider Business Mailing Address
First Line	:	1126 19TH ST
Second Line	:
City	:	HERMOSA BEACH
State	:	CA
Zip	:	90254-3306
Country	:	US
Telephone Number	:	310-695-8033
Fax Number	:

Provider Business Practice Location Address
First Line	:	1126 19TH ST
Second Line	:
City	:	HERMOSA BEACH
State	:	CA
Zip	:	90254-3306
Country	:	US
Telephone Number	:	310-695-8033
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/22/2009
Last Update Date	:	10/04/2025

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