Individual
MS. BETHANY ELAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
315 MEDINA WAY, NEWPORT BEACH, CA 92661-1215
(703) 598-5087
Mailing address
315 MEDINA WAY, NEWPORT BEACH, CA 92661-1215
(703) 598-5087
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
958358
—
Other
Enumeration date
08/17/2010
Last updated
08/17/2010
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