MEDICARE: MR. JAIME LARA CLINICAL NUTRITION

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	133NN1002X	Nutrition Education Nutritionist

General Provider Information

NPI Number	:	1245564624
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. JAIME LARA CLINICAL NUTRITION

Provider Business Mailing Address
First Line	:	2730 GWYNNE AVE
Second Line	:
City	:	NATIONAL CITY
State	:	CA
Zip	:	91950-7721
Country	:	US
Telephone Number	:	619-987-3232
Fax Number	:	619-474-6061

Provider Business Practice Location Address
First Line	:	1247 HIGHLAND AVE
Second Line	:	SUITE # 4
City	:	NATIONAL CITY
State	:	CA
Zip	:	91950-3552
Country	:	US
Telephone Number	:	619-987-3232
Fax Number	:	619-474-6061

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

Provider Enumeration Date	:	10/01/2009
Last Update Date	:	10/01/2009

Similar Medicare Providers

1588685267 — CUSTOM QUALITY OPTICAL
Practice Location Address:

1632 PAT BOOKER RD , SUITE 124
UNIVERSAL CITY, TX
78148-3552

Practice Phone: 210-945-9226
Practice Fax: 210-566-5914

1629514757 — MRS. MADISON MILLER
Practice Location Address:

3552 FM 1092 RD
MISSOURI CITY, TX
77459-2203

Practice Phone: 346-368-4412
Practice Fax: 855-742-3123

1821574559 — PASSIONA LA'VELLE THOMPSON RBT
Practice Location Address:

3552 FM 1092 RD
MISSOURI CITY, TX
77459

Practice Phone: 346-368-4412
Practice Fax:

1851876858 — BEVERLY CLANCY
Practice Location Address:

601 FRANKLIN ST STE 103
MICHIGAN CITY, IN
46360-3552

Practice Phone: 219-877-4772
Practice Fax:

1952961922 — CHLOE ROGERS
Practice Location Address:

3552 FM 1092 RD
MISSOURI CITY, TX
77459-2203

Practice Phone: 346-368-4421
Practice Fax:

1598398851 — REMY RENE ELIAS
Practice Location Address:

3552 FM 1092 RD
MISSOURI CITY, TX
77459-2203

Practice Phone: 346-368-4412
Practice Fax:

Directions to “ MR. JAIME LARA CLINICAL NUTRITION” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2025 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.