Basic Information
| Provider Information | |||||||||
| NPI: | 1427359520 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BELLO | ||||||||
| FirstName: | PADRAIC | ||||||||
| MiddleName: | ANDREW | ||||||||
| NamePrefix: | MR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | RD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1334 SOUTH AVENUE B | ||||||||
| Address2: | 134 | ||||||||
| City: | YUMA | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 853642418 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9283048632 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 2400 S AVENUE A | ||||||||
| Address2: | |||||||||
| City: | YUMA | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 853647127 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9283442000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 11/05/2010 | ||||||||
| LastUpdateDate: | 04/20/2011 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 133V00000X | 1049580 | Y | Dietary & Nutritional Service Providers | Dietitian, Registered | 133V00000X | 6614 | OH | N | Dietary & Nutritional Service Providers | Dietitian, Registered |
No ID Information.