Provider Demographics
NPI:1154708741
Name:TINDARO, SARA (RD)
Entity type:Individual
Prefix:
First Name:SARA
Middle Name:
Last Name:TINDARO
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 1:5542 CORAL REEF AVE
Mailing Address - Street 2:
Mailing Address - City:LA JOLLA
Mailing Address - State:CA
Mailing Address - Zip Code:92037-7028
Mailing Address - Country:US
Mailing Address - Phone:858-967-2017
Mailing Address - Fax:
Practice Address - Street 1:888 PROSPECT ST
Practice Address - Street 2:SUITE 200
Practice Address - City:LA JOLLA
Practice Address - State:CA
Practice Address - Zip Code:92037-4260
Practice Address - Country:US
Practice Address - Phone:858-967-2017
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-05-03
Last Update Date:2015-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered