Provider Demographics
NPI:1295144681
Name:SAID, MADELEINE (RD CDE)
Entity type:Individual
Prefix:
First Name:MADELEINE
Middle Name:
Last Name:SAID
Suffix:
Gender:F
Credentials:RD CDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19581 GRANDVIEW CIR
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92648-5571
Mailing Address - Country:US
Mailing Address - Phone:301-602-8002
Mailing Address - Fax:
Practice Address - Street 1:19581 GRANDVIEW CIR
Practice Address - Street 2:
Practice Address - City:HUNTINGTON BEACH
Practice Address - State:CA
Practice Address - Zip Code:92648-5571
Practice Address - Country:US
Practice Address - Phone:301-602-8002
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-11
Last Update Date:2016-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCDI100000509133VN1006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133VN1006XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Metabolic