Provider Demographics
NPI:1790294569
Name:MROWCZYNSKI-HERNANDEZ, PAULA KINGA (RD, MED, CSSD)
Entity Type:Individual
Prefix:
First Name:PAULA
Middle Name:KINGA
Last Name:MROWCZYNSKI-HERNANDEZ
Suffix:
Gender:F
Credentials:RD, MED, CSSD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4650 W SUNSET BLVD # 8
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90027-6062
Mailing Address - Country:US
Mailing Address - Phone:713-248-4690
Mailing Address - Fax:
Practice Address - Street 1:4650 W SUNSET BLVD # 8
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90027-6062
Practice Address - Country:US
Practice Address - Phone:713-248-4690
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-09-25
Last Update Date:2017-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered