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NPI Code Detail

MEDICARE: RUTH ARELI ESCALANTE RD

MEDICARE: RUTH ARELI ESCALANTE 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
1133V00000XRegistered DietitianMI

General Provider Information

NPI Number : 1063910123
Entity Type Code : Individual
Provider Name (Legal Business Name) : RUTH ARELI ESCALANTE RD
Provider Business Mailing Address
First Line : 20500 BELSHAW AVE # EXCA1377
Second Line :
City : CARSON
State : CA
Zip : 90746-3506
Country : US
Telephone Number : 415-989-1017
Fax Number :
Provider Business Practice Location Address
First Line : 20500 BELSHAW AVE # EXCA1377
Second Line :
City : CARSON
State : CA
Zip : 90746-3506
Country : US
Telephone Number : 415-989-1017
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/24/2018
Last Update Date : 07/24/2024

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