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Individual

ANTHONY MAZZA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
607 DONNA WAY, SAN JACINTO, CA 92583-5517
(951) 654-0803
Mailing address
607 DONNA WAY, SAN JACINTO, CA 92583-5517
(951) 654-0803

Taxonomy

Speciality
Code
Description
License number
State
133NN1002X
Nutrition Education Nutritionist
1055958
CA
133V00000X
Registered Dietitian
Primary
1055958
CA

Other

Enumeration date
10/17/2014
Last updated
10/17/2014
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