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Individual

MISS MEGAN M BISHOP

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
B.S., NUTRITIONIST

Contact information

Practice address
90 LOS VERDES DR, SAN LUIS OBISPO, CA 93401-7731
(559) 246-6377
Mailing address
90 LOS VERDES DR, SAN LUIS OBISPO, CA 93401-7731
(559) 246-6377

Taxonomy

Speciality
Code
Description
License number
State
133N00000X
Nutritionist
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
SLWG 77319A
PHYSICIAN REFERRAL
CA
Enumeration date
02/16/2010
Last updated
02/16/2010
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