Individual
IRYANTHI KURNIADI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
R.D.
Contact information
Practice address
18324 JEFFREY AVE, CERRITOS, CA 90703-6149
(562) 739-3944
Mailing address
18324 JEFFREY AVE, CERRITOS, CA 90703-6149
(562) 739-3944
Taxonomy
Speciality
Code
Description
License number
State
133VN1005X
Renal Nutrition Registered Dietitian
Primary
883003
CA
Other
Enumeration date
01/15/2013
Last updated
01/15/2013
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