Doctor Name: | MARTHA JEAN GRAY |
NPI Number: | 1366544108 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | RD |
License Number: | R166117 |
Business Practice Address: | 26991 Crown Valley Pkwy Mission Viejo, CA - 926916528 |
Business Phone Number: | 9495822002 |
Business Fax Number: | 9493675200 |
Mailing Address: | 2742 Dow Ave, TUSTIN |
State: | CA |
Postal Code: | 927807242 |
Phone Number: | 7146651600 |
Fax Number: | |
NPI Enumeration Date: | 09/02/2006 |
NPI Last Update Date: | 03/31/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 133V00000X |
License Number: | R166117 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TN |
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 |