Provider Demographics
NPI:1679692420
Name:MCINTYRE, KARINA (RD)
Entity Type:Individual
Prefix:MS
First Name:KARINA
Middle Name:
Last Name:MCINTYRE
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3425 STADIUM PL
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92122-3308
Mailing Address - Country:US
Mailing Address - Phone:619-917-4408
Mailing Address - Fax:
Practice Address - Street 1:3425 STADIUM PL
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92122-3308
Practice Address - Country:US
Practice Address - Phone:619-917-4408
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-29
Last Update Date:2020-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA949107133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered