Provider Demographics
NPI:1427329580
Name:MAGERS, NICHOLAS (RD)
Entity type:Individual
Prefix:MR
First Name:NICHOLAS
Middle Name:
Last Name:MAGERS
Suffix:
Gender:M
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:700 W HARBOR DR
Mailing Address - Street 2:STE. #1804
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92101-7753
Mailing Address - Country:US
Mailing Address - Phone:949-355-7288
Mailing Address - Fax:
Practice Address - Street 1:3194 VIA DE CABALLO
Practice Address - Street 2:
Practice Address - City:ENCINITAS
Practice Address - State:CA
Practice Address - Zip Code:92024-6925
Practice Address - Country:US
Practice Address - Phone:949-355-7288
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-21
Last Update Date:2013-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA857939133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered