Provider Demographics
NPI:1093268021
Name:ALESSANDRINI, CARLOS GILBERTO III (NUTRITIONIST)
Entity Type:Individual
Prefix:
First Name:CARLOS
Middle Name:GILBERTO
Last Name:ALESSANDRINI
Suffix:III
Gender:M
Credentials:NUTRITIONIST
Other - Prefix:
Other - First Name:CARLOS
Other - Middle Name:GILBERTO
Other - Last Name:ALESSANDRINI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:NUTRITIONIST
Mailing Address - Street 1:1809 NATIONAL AVE
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92113-2113
Mailing Address - Country:US
Mailing Address - Phone:619-515-2526
Mailing Address - Fax:
Practice Address - Street 1:1809 NATIONAL AVE
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92113-2113
Practice Address - Country:US
Practice Address - Phone:619-515-2526
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-07-26
Last Update Date:2016-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ZZ64150133N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133N00000XDietary & Nutritional Service ProvidersNutritionist