Provider Demographics
NPI:1275674244
Name:LONDON, KARIN N (MPH, RD)
Entity Type:Individual
Prefix:MRS
First Name:KARIN
Middle Name:N
Last Name:LONDON
Suffix:
Gender:F
Credentials:MPH, RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11311 KELLY LN
Mailing Address - Street 2:
Mailing Address - City:LOS ALAMITOS
Mailing Address - State:CA
Mailing Address - Zip Code:90720-3939
Mailing Address - Country:US
Mailing Address - Phone:562-596-1921
Mailing Address - Fax:
Practice Address - Street 1:11311 KELLY LN
Practice Address - Street 2:
Practice Address - City:LOS ALAMITOS
Practice Address - State:CA
Practice Address - Zip Code:90720-3939
Practice Address - Country:US
Practice Address - Phone:562-596-1921
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA717743133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered