Individual
MS. CHANEL NICOLE SUARES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
R.D.
Contact information
Practice address
200 UCLA MEDICAL PLAZA SUITE 265, LOS ANGELES, CA 90074-6114
(310) 301-8860
Mailing address
5767 W CENTURY BLVD STE 400, LOS ANGELES, CA 90045-5631
(310) 301-5200
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
86029129
CA
133VN1006X
Metabolic Nutrition Registered Dietitian
Primary
86029129
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
86029129
COMMISSION ON DIETETIC REGISTRATION
CA
Enumeration date
10/08/2014
Last updated
02/27/2024
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