Provider Demographics
NPI:1790459915
Name:PAULINE CHAU NUTRITION, LLC
Entity Type:Organization
Organization Name:PAULINE CHAU NUTRITION, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGISTERED DIETITIAN
Authorized Official - Prefix:
Authorized Official - First Name:PAULINE
Authorized Official - Middle Name:P
Authorized Official - Last Name:CHAU
Authorized Official - Suffix:
Authorized Official - Credentials:RD, CDCES
Authorized Official - Phone:650-678-2904
Mailing Address - Street 1:2840 WAKEFIELD DR
Mailing Address - Street 2:
Mailing Address - City:BELMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94002-2935
Mailing Address - Country:US
Mailing Address - Phone:650-678-2904
Mailing Address - Fax:
Practice Address - Street 1:1828 EL CAMINO REAL STE 407
Practice Address - Street 2:
Practice Address - City:BURLINGAME
Practice Address - State:CA
Practice Address - Zip Code:94010-3115
Practice Address - Country:US
Practice Address - Phone:650-678-2904
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-02
Last Update Date:2021-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty