Provider Demographics
NPI:1649896895
Name:OBREITER, MEGAN GREER (RD)
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:GREER
Last Name:OBREITER
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 1:4804 LAUREL CANYON BLVD
Mailing Address - Street 2:# 190
Mailing Address - City:VALLEY VILLAGE
Mailing Address - State:CA
Mailing Address - Zip Code:91607-3717
Mailing Address - Country:US
Mailing Address - Phone:818-394-0166
Mailing Address - Fax:
Practice Address - Street 1:5510 CORTEEN PL APT 3
Practice Address - Street 2:
Practice Address - City:VALLEY VILLAGE
Practice Address - State:CA
Practice Address - Zip Code:91607-1647
Practice Address - Country:US
Practice Address - Phone:818-394-0166
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-23
Last Update Date:2020-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA86092274133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty