Individual
ALEIDA GORDON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
2452 N TEAKWOOD AVE, RIALTO, CA 92377-4247
(909) 875-1591
(909) 875-1591
Mailing address
2452 N TEAKWOOD AVE, RIALTO, CA 92377-4247
(909) 875-1591
Taxonomy
Speciality
Code
Description
License number
State
133N00000X
Nutritionist
R800457
IL
133NN1002X
Nutrition Education Nutritionist
Primary
R800457
IL
Other
Enumeration date
06/28/2017
Last updated
11/02/2020
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