Individual
CISSY GU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
1317 LONGHORN DR, SAN DIMAS, CA 91773-1152
(909) 971-9204
(909) 971-9206
Mailing address
1317 LONGHORN DR, SAN DIMAS, CA 91773-1152
(909) 971-9204
(909) 971-9206
Taxonomy
Speciality
Code
Description
License number
State
133VN1005X
Renal Nutrition Registered Dietitian
Primary
866115
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
866115
RD LICENSE
CA
Enumeration date
09/07/2007
Last updated
09/07/2007
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