Provider Demographics
NPI:1194409151
Name:REZA, JOSEPH FELIX (RD/N, CPT, CHC)
Entity type:Individual
Prefix:
First Name:JOSEPH
Middle Name:FELIX
Last Name:REZA
Suffix:
Gender:M
Credentials:RD/N, CPT, CHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:904 RAYWOOD PL
Mailing Address - Street 2:
Mailing Address - City:MONTEBELLO
Mailing Address - State:CA
Mailing Address - Zip Code:90640-2839
Mailing Address - Country:US
Mailing Address - Phone:323-353-8918
Mailing Address - Fax:
Practice Address - Street 1:904 RAYWOOD PL
Practice Address - Street 2:
Practice Address - City:MONTEBELLO
Practice Address - State:CA
Practice Address - Zip Code:90640-2839
Practice Address - Country:US
Practice Address - Phone:323-353-8918
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-12
Last Update Date:2023-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered