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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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