Provider Demographics
NPI:1023387172
Name:GUENTNER, STEWART D (REGISTERED DIETITIAN)
Entity Type:Individual
Prefix:
First Name:STEWART
Middle Name:D
Last Name:GUENTNER
Suffix:
Gender:M
Credentials:REGISTERED DIETITIAN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:495 BORDEN CIR
Mailing Address - Street 2:
Mailing Address - City:SAN MARCOS
Mailing Address - State:CA
Mailing Address - Zip Code:92069-1841
Mailing Address - Country:US
Mailing Address - Phone:760-435-2308
Mailing Address - Fax:
Practice Address - Street 1:495 BORDEN CIR
Practice Address - Street 2:
Practice Address - City:SAN MARCOS
Practice Address - State:CA
Practice Address - Zip Code:92069-1841
Practice Address - Country:US
Practice Address - Phone:760-435-2308
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-19
Last Update Date:2013-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA00721609133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered