Provider Demographics
NPI:1033205067
Name:ARNOLD, DIANA SOOBITSKY (RD, LDN, MPH)
Entity Type:Individual
Prefix:
First Name:DIANA
Middle Name:SOOBITSKY
Last Name:ARNOLD
Suffix:
Gender:F
Credentials:RD, LDN, MPH
Other - Prefix:
Other - First Name:DIANA
Other - Middle Name:S
Other - Last Name:ARNOLD
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:SAME
Mailing Address - Street 1:3640 TURNBULL CANYON ROAD
Mailing Address - Street 2:
Mailing Address - City:HACIENDA HEIGHTS
Mailing Address - State:CA
Mailing Address - Zip Code:91745-5030
Mailing Address - Country:US
Mailing Address - Phone:562-698-7111
Mailing Address - Fax:562-698-8010
Practice Address - Street 1:3640 TURNBULL CANYON ROAD
Practice Address - Street 2:
Practice Address - City:HACIENDA HEIGHTS
Practice Address - State:CA
Practice Address - Zip Code:91745-5030
Practice Address - Country:US
Practice Address - Phone:562-698-7111
Practice Address - Fax:562-698-8010
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA1899133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1899OtherLICENSED DIETITIAN/NUTRIT
R15921OtherDIETETIC REG. #