Organization
BASAL NUTRITION LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DUSTIN GEORGE FRISTED RD (OWNER/AUTHORIZED OFFICIAL)
(714) 955-3545
Entity
Organization
Contact information
Practice address
43020 BLACK DEER LOOP STE 206, TEMECULA, CA 92590-3406
(951) 238-7725
Mailing address
43020 BLACK DEER LOOP STE 206, TEMECULA, CA 92590-3406
(714) 955-3545
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
—
Other
Enumeration date
08/17/2022
Last updated
08/17/2022
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