| Doctor Name: | MIRIAM GERALDINE MATULICH |
| NPI Number: | 1346281672 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | RD |
| License Number: | 464982 |
| Business Practice Address: | 1 Hoag Drive Newport Beach, CA - 92663 |
| Business Phone Number: | 9497648321 |
| Business Fax Number: | 9497648055 |
| Mailing Address: | 9211 Ski Harbor Cir, HUNTINGTON BEACH |
| State: | CA |
| Postal Code: | 926466313 |
| Phone Number: | 7149645440 |
| Fax Number: | |
| NPI Enumeration Date: | 06/09/2006 |
| NPI Last Update Date: | 09/20/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 133V00000X |
| License Number: | 464982 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| 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 |