Individual
TINA PAUL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
144 W SIERRA MADRE BLVD, SIERRA MADRE, CA 91024-2435
(407) 234-0855
Mailing address
510 FOOTHILL AVE, SIERRA MADRE, CA 91024-1521
(407) 234-0855
Taxonomy
Speciality
Code
Description
License number
State
133N00000X
Nutritionist
Primary
—
—
Other
Enumeration date
12/18/2013
Last updated
12/18/2013
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