| Doctor Name: | MR. GREGORY GAGE WINE |
| NPI Number: | 1801023973 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MSRD |
| License Number: | |
| Business Practice Address: | 2315 Stockton Blvd Ste 0102 Sacramento, CA - 958172201 |
| Business Phone Number: | 9167033117 |
| Business Fax Number: | 9167033118 |
| Mailing Address: | 2315 Stockton Blvd, Ste 0102 SACRAMENTO |
| State: | CA |
| Postal Code: | 958172201 |
| Phone Number: | 9167033117 |
| Fax Number: | 9167033118 |
| NPI Enumeration Date: | 06/16/2009 |
| NPI Last Update Date: | 06/16/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 133V00000X |
| License Number: | |
| 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 |