Provider Demographics
NPI:1538280631
Name:PIZZO, JOHN PAUL (RD)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:PAUL
Last Name:PIZZO
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 1:4831 MOUNT BIGELOW DR
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92111-2525
Mailing Address - Country:US
Mailing Address - Phone:619-956-2968
Mailing Address - Fax:619-956-2947
Practice Address - Street 1:9065 EDGEMOOR DR
Practice Address - Street 2:
Practice Address - City:SANTEE
Practice Address - State:CA
Practice Address - Zip Code:92071-3037
Practice Address - Country:US
Practice Address - Phone:619-956-2968
Practice Address - Fax:619-956-2947
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
719647133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered