Provider Demographics
NPI:1720325681
Name:SAUL, EVA MARGARETA (RD, IBCLC)
Entity Type:Individual
Prefix:
First Name:EVA
Middle Name:MARGARETA
Last Name:SAUL
Suffix:
Gender:F
Credentials:RD, IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:505 E DATE ST
Mailing Address - Street 2:
Mailing Address - City:BREA
Mailing Address - State:CA
Mailing Address - Zip Code:92821-5404
Mailing Address - Country:US
Mailing Address - Phone:714-990-4461
Mailing Address - Fax:714-990-4461
Practice Address - Street 1:505 E DATE ST
Practice Address - Street 2:
Practice Address - City:BREA
Practice Address - State:CA
Practice Address - Zip Code:92821-5404
Practice Address - Country:US
Practice Address - Phone:714-990-4461
Practice Address - Fax:714-990-4461
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-12
Last Update Date:2013-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA851886133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered