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Individual

MARLA MARILES

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RD

Contact information

Practice address
150 W ROUTE 66, GLENDORA, CA 91740-6207
(626) 852-5000
Mailing address
6413 CLOVER ST, CHINO, CA 91710-5368
(909) 917-8596

Taxonomy

Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
1047230

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1047230
COMMISSION ON DIETETIC REGISTRATION
Enumeration date
07/22/2015
Last updated
07/22/2015
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