Individual
ELIZABETH BOLDUC
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
2138 LOGGIA, NEWPORT BEACH, CA 92660-9038
(949) 338-4154
Mailing address
PO BOX 80912, SAN MARINO, CA 91118-8912
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
86046375
CA
Other
Enumeration date
05/17/2019
Last updated
01/11/2022
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