Individual
AMY PAO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
254 JACKSON ST, HAYWARD, CA 94544-1907
(510) 583-1255
Mailing address
10858 MCPEAK LN, DUBLIN, CA 94568-5500
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
991162
CDR
—
Enumeration date
10/21/2019
Last updated
10/21/2019
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