Provider Demographics
NPI:1801951975
Name:UTUCHIAN, NAZIK COROMOTO (RD, MPH)
Entity type:Individual
Prefix:MS
First Name:NAZIK
Middle Name:COROMOTO
Last Name:UTUCHIAN
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Gender:F
Credentials:RD, MPH
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Mailing Address - Street 1:2426 CANADA BLVD
Mailing Address - Street 2:# 2
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91208-1968
Mailing Address - Country:US
Mailing Address - Phone:818-468-9403
Mailing Address - Fax:818-500-9700
Practice Address - Street 1:540 N CENTRAL AVE
Practice Address - Street 2:SUITE # 303
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91203-1916
Practice Address - Country:US
Practice Address - Phone:818-500-9996
Practice Address - Fax:818-500-9700
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-27
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CA810411133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered