Provider Demographics
NPI:1619511227
Name:MANITIUS, NATALIE LAURA (MPH, RDN)
Entity Type:Individual
Prefix:
First Name:NATALIE
Middle Name:LAURA
Last Name:MANITIUS
Suffix:
Gender:F
Credentials:MPH, RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1223 16TH ST STE 3100
Mailing Address - Street 2:
Mailing Address - City:SANTA MONICA
Mailing Address - State:CA
Mailing Address - Zip Code:90404-1275
Mailing Address - Country:US
Mailing Address - Phone:310-582-6240
Mailing Address - Fax:
Practice Address - Street 1:1223 16TH ST STE 3100
Practice Address - Street 2:
Practice Address - City:SANTA MONICA
Practice Address - State:CA
Practice Address - Zip Code:90404-1275
Practice Address - Country:US
Practice Address - Phone:310-582-6240
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-11-06
Last Update Date:2023-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered