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Individual

MAHTAB MORIDI

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RD

Contact information

Practice address
250 HOSPITAL PKWY, SAN JOSE, CA 95119-1103
(408) 972-3000
Mailing address
4400 THE WOODS DR APT 1905, SAN JOSE, CA 95136-3866
(916) 337-7627

Taxonomy

Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
86082851
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
101-84-115
KAISER
CA
Enumeration date
07/02/2019
Last updated
11/22/2021
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