Individual
MISS CHRISTINA MARIE FASULO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS RD
Contact information
Practice address
100 UCLA MEDICAL PLAZA SUITE 345, LOS ANGELES, CA 90095-1804
(310) 208-5400
Mailing address
5767 W CENTURY BLVD STE 400, LOS ANGELES, CA 90045-5631
(310) 301-8707
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
86048802
CA
Other
Enumeration date
04/24/2019
Last updated
09/01/2023
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