Provider Demographics
NPI:1336529379
Name:CHRISTOPHER-IPAKTCHIAN, MICHELE (MS, RD)
Entity Type:Individual
Prefix:
First Name:MICHELE
Middle Name:
Last Name:CHRISTOPHER-IPAKTCHIAN
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 1:1428 26TH ST APT D
Mailing Address - Street 2:
Mailing Address - City:SANTA MONICA
Mailing Address - State:CA
Mailing Address - Zip Code:90404-3075
Mailing Address - Country:US
Mailing Address - Phone:310-760-1087
Mailing Address - Fax:
Practice Address - Street 1:1428 26TH ST APT D
Practice Address - Street 2:
Practice Address - City:SANTA MONICA
Practice Address - State:CA
Practice Address - Zip Code:90404-3075
Practice Address - Country:US
Practice Address - Phone:310-760-1087
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-04
Last Update Date:2021-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered