Russo, Sandra Geraldine

Russo, Sandra Geraldine is an individual health care provider with primary practice located at 2925 Palo Verde Ave , Long Beach CA 90815-1552. She recently has only one registered license in Dietary & Nutritional Service Providers / Nutrition, Metabolic, which is considered as her primary health care specialty. Russo, Sandra Geraldine can be contacted via phone (562) 429-2473.

Contact Information

Primary practice address
2925 Palo Verde Ave Long Beach CA 90815-1552
Phone: (562) 429-2473
Fax: (562) 496-5577
Website:
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Health care specialties

SpecialtyCodeLicense #State
Dietary & Nutritional Service Providers / Nutrition, Metabolic 133VN1006X 838417 California

Profile Details

NPI number 1467657767
LBN Legal business name Russo, Sandra Geraldine
Credentials Registered Dietitian (RD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 18th, 2007
Last updated Aug 26th, 2008 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1467657767 NPPES
California Other 8381417 CDR

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