Sd Medical Nutrition Therapy, Pc

Specialty details in registry · San Diego, CA

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At a glance

11365 Mandrake Pt, San Diego, CA 92131-3766

NPPES record updated Apr 3, 2024. Public records can lag behind changes at a practice.

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Practice location

11365 Mandrake Pt
San Diego, CA 92131-3766

Professional details: NPI, taxonomy & registry record

NPI1861244774

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Registry details

Primary taxonomy: Specialty details in registry
Taxonomy code: 133V00000X
Enumeration date: Apr 3, 2024
Record updated: Apr 3, 2024

More registry details

Provider type: Organization · Type 2

Reported taxonomies and licenses

Specialty details in registry

133V00000X · Primary

License numbers and credentials are reported to NPPES; HCPList does not independently verify them.

Practice location

11365 Mandrake Pt
San Diego, CA 92131-3766

Phone: (619) 736-9020

Mailing address

11365 MANDRAKE PT

SAN DIEGO, CA 921313766

Source: NPPES Source through Oct 18, 2026An NPI does not verify licensure or credentials.

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