Provider Demographics
NPI:1770953697
Name:EL MEZAIN, TASNIM (RDN)
Entity type:Individual
Prefix:
First Name:TASNIM
Middle Name:
Last Name:EL MEZAIN
Suffix:
Gender:F
Credentials:RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7131 PRINCESS VIEW DR
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92120-1329
Mailing Address - Country:US
Mailing Address - Phone:858-357-1339
Mailing Address - Fax:
Practice Address - Street 1:7131 PRINCESS VIEW DR
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92120-1329
Practice Address - Country:US
Practice Address - Phone:858-357-1339
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-05
Last Update Date:2015-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA86041631133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered