MEDICARE: ELIZABETH DUDEK N.D.

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	175F00000X	Naturopath	ND691	CA

General Provider Information

NPI Number	:	1649637299
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELIZABETH DUDEK N.D.

Provider Business Mailing Address
First Line	:	1525 LUNETA DR
Second Line	:	UNIT B
City	:	DEL MAR
State	:	CA
Zip	:	92014-2432
Country	:	US
Telephone Number	:	858-242-2780
Fax Number	:

Provider Business Practice Location Address
First Line	:	1525 LUNETA DR
Second Line	:	UNIT B
City	:	DEL MAR
State	:	CA
Zip	:	92014-2432
Country	:	US
Telephone Number	:	858-242-2780
Fax Number	:

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

Provider Enumeration Date	:	01/26/2016
Last Update Date	:	01/26/2016

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