Provider Demographics
NPI:1649582115
Name:BOBBIN, MARILYN (MS, RD)
Entity Type:Individual
Prefix:
First Name:MARILYN
Middle Name:
Last Name:BOBBIN
Suffix:
Gender:F
Credentials:MS, RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:843 ROBLE AVE
Mailing Address - Street 2:#3
Mailing Address - City:MENLO PARK
Mailing Address - State:CA
Mailing Address - Zip Code:94025-4946
Mailing Address - Country:US
Mailing Address - Phone:650-353-8615
Mailing Address - Fax:
Practice Address - Street 1:843 ROBLE AVE
Practice Address - Street 2:#3
Practice Address - City:MENLO PARK
Practice Address - State:CA
Practice Address - Zip Code:94025-4946
Practice Address - Country:US
Practice Address - Phone:650-353-8615
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-13
Last Update Date:2010-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered