Individual
ANN MO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
158 W COLLEGE ST, COVINA, CA 91723-2007
(626) 859-2522
(626) 331-0175
Mailing address
3510 E HILLHAVEN DR, WEST COVINA, CA 91791-1719
(626) 416-8566
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
—
—
133VN1005X
Renal Nutrition Registered Dietitian
Primary
—
—
Other
Enumeration date
06/28/2013
Last updated
06/28/2013
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