| Organization Name: | DIABETES WELLNESS CENTER, A NURSING CORPORATION |
| NPI Number: | 1487653036 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | KRISTINA N DILWORTH (PRESIDENT) |
| Mailing Address: | 855 4th St #2 Pismo Beach |
| State: | CA US |
| Postal Code: | 934493102 |
| Phone Number: | 8057733130 |
| Fax Number: | 8057733120 |
| NPI Enumeration Date: | 07/16/2005 |
| NPI Last Update Date: | 05/05/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 133VN1006X |
| License Number: | C2445484 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Dietary & Nutritional Service Providers |
| Taxonomy Classification: | Dietitian, Registered |
| Taxonomy Specialization: | Nutrition, Metabolic |
| Taxonomy Definition: | |