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Organization
VANDENBERG AIR FORCE 30TH MEDICAL GROUP
Active
Organization
VANDENBERG AIR FORCE 30TH MEDICAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARY MUTAGALOA-WALKER REGISTERED DIETITIAN (HEALTH PROMOTION DIETITIAN)
(805) 606-3469
Entity
Organization
Contact information
Practice address
338 S DAKOTA AVE BLDG 13850, LOMPOC, CA 93437-6307
(805) 606-3469
Mailing address
338 S DAKOTA AVE BLDG 13850, LOMPOC, CA 93437-6307
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
—
Other
Enumeration date
09/13/2019
Last updated
03/04/2025
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