Individual
CYNTHIA L. FAIRMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD CDE
Contact information
Practice address
6555 COYLE AVE, CARMICHAEL, CA 95608-0302
(916) 536-3540
Mailing address
1702 MORAGA WAY, ROSEVILLE, CA 95661-5763
(916) 786-2235
Taxonomy
Speciality
Code
Description
License number
State
133N00000X
Nutritionist
Primary
508221
CA
Other
Enumeration date
03/05/2007
Last updated
07/08/2007
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