Individual
ALVARO LICTO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RD
Contact information
Practice address
47923 OASIS ST, INDIO, CA 92201-9788
(760) 863-8268
Mailing address
47923 OASIS ST, INDIO, CA 92201-9788
(760) 863-8268
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
954507
CA
Other
Enumeration date
01/23/2008
Last updated
01/23/2008
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