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NPI Code Detail

MEDICARE: MRS. NICOLE DANIELLE EICHINGER RD

MEDICARE: MRS. NICOLE DANIELLE EICHINGER 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 Dietitian997901TX

General Provider Information

NPI Number : 1366072803
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. NICOLE DANIELLE EICHINGER RD
Provider Business Mailing Address
First Line : 2407 ADAMS AVE # 20
Second Line :
City : SAN DIEGO
State : CA
Zip : 92116-1303
Country : US
Telephone Number : 806-239-4426
Fax Number :
Provider Business Practice Location Address
First Line : 2407 ADAMS AVE # 20
Second Line :
City : SAN DIEGO
State : CA
Zip : 92116-1303
Country : US
Telephone Number : 806-239-4426
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/23/2020
Last Update Date : 01/23/2020

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