Provider Demographics
NPI:1982298147
Name:DANGI, SUMAN (RD, RDN)
Entity Type:Individual
Prefix:MR
First Name:SUMAN
Middle Name:
Last Name:DANGI
Suffix:
Gender:M
Credentials:RD, RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23409 MOUNT ASHLAND CT
Mailing Address - Street 2:
Mailing Address - City:MURRIETA
Mailing Address - State:CA
Mailing Address - Zip Code:92562-5015
Mailing Address - Country:US
Mailing Address - Phone:909-968-6808
Mailing Address - Fax:
Practice Address - Street 1:23409 MOUNT ASHLAND CT
Practice Address - Street 2:
Practice Address - City:MURRIETA
Practice Address - State:CA
Practice Address - Zip Code:92562-5015
Practice Address - Country:US
Practice Address - Phone:909-968-6808
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-26
Last Update Date:2023-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
86071024133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered