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NPI Code Detail

MEDICARE: STEPHANIE MITSUYE DACAY R.D.

MEDICARE:   STEPHANIE MITSUYE DACAY  R.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
1133V00000XRegistered Dietitian887163CA

General Provider Information

NPI Number : 1841348059
Entity Type Code : Individual
Provider Name (Legal Business Name) : STEPHANIE MITSUYE DACAY R.D.
Provider Business Mailing Address
First Line : 4650 W SUNSET BLVD
Second Line :
City : LOS ANGELES
State : CA
Zip : 90027-6062
Country : US
Telephone Number : 310-210-3778
Fax Number :
Provider Business Practice Location Address
First Line : 1925 S BARRINGTON AVE
Second Line :
City : WEST LOS ANGELES
State : CA
Zip : 90025-5318
Country : US
Telephone Number : 310-210-3778
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/08/2007
Last Update Date : 09/16/2010

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Directions to “ STEPHANIE MITSUYE DACAY R.D.” Practice Location

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