Provider Demographics
NPI:1326767971
Name:TSOY, DMITRIY (RD)
Entity Type:Individual
Prefix:
First Name:DMITRIY
Middle Name:
Last Name:TSOY
Suffix:
Gender:M
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1921 22ND ST
Mailing Address - Street 2:
Mailing Address - City:OCEANO
Mailing Address - State:CA
Mailing Address - Zip Code:93445-9045
Mailing Address - Country:US
Mailing Address - Phone:650-201-1085
Mailing Address - Fax:
Practice Address - Street 1:1418 E MAIN ST STE 210
Practice Address - Street 2:
Practice Address - City:SANTA MARIA
Practice Address - State:CA
Practice Address - Zip Code:93454-4836
Practice Address - Country:US
Practice Address - Phone:805-928-3678
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-25
Last Update Date:2022-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered