Doctor Name: | GWENDOLYN MOORE |
NPI Number: | 1144363037 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MPH, RD |
License Number: | 976489 |
Business Practice Address: | 7777 Milliken Ave Ste 360 #2 Rancho Cucamonga, CA - 917306782 |
Business Phone Number: | 7145523802 |
Business Fax Number: | 8667044779 |
Mailing Address: | 393 White Cap Ln, NEWPORT COAST |
State: | CA |
Postal Code: | 926571096 |
Phone Number: | 7145523802 |
Fax Number: | 8667044779 |
NPI Enumeration Date: | 02/14/2007 |
NPI Last Update Date: | 04/20/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 133V00000X |
License Number: | 976489 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Dietary & Nutritional Service Providers |
Taxonomy Classification: | Dietitian, Registered |
Taxonomy Specialization: | |
Taxonomy Definition: | A registered dietician (RD) is a food and nutrition expert who has successfully completed a minimum of a bachelor |