Individual
MS. ELAINE TIZZ GROSSMAN
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
M.S., R.D.
Contact information
Practice address
STURGIS STREET BLDG. 1145, BOX 788250, TWENTYNINE PALMS, CA 92278-8250
(760) 830-2120
Mailing address
STURGIS STREET BLDG. 1145, BOX 788250, TWENTYNINE PALMS, CA 92278-8250
(760) 830-2120
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
700227
NATIONAL CERTIFICATION
—
Enumeration date
12/14/2005
Last updated
07/08/2007
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