Provider Demographics
NPI:1912704313
Name:CLINICAL DIETITIAN SOLUTIONS, LLC
Entity type:Organization
Organization Name:CLINICAL DIETITIAN SOLUTIONS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARIA RODELITA
Authorized Official - Middle Name:DEYPALAN
Authorized Official - Last Name:ODONO
Authorized Official - Suffix:
Authorized Official - Credentials:RDN, MS
Authorized Official - Phone:626-416-8895
Mailing Address - Street 1:2960 HUNTINGTON DR # 80813
Mailing Address - Street 2:
Mailing Address - City:SAN MARINO
Mailing Address - State:CA
Mailing Address - Zip Code:91108-2237
Mailing Address - Country:US
Mailing Address - Phone:626-620-1908
Mailing Address - Fax:
Practice Address - Street 1:330 N CHAPEL AVE APT 103
Practice Address - Street 2:
Practice Address - City:ALHAMBRA
Practice Address - State:CA
Practice Address - Zip Code:91801-2583
Practice Address - Country:US
Practice Address - Phone:626-416-8895
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-02-25
Last Update Date:2025-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty