LIGHTHOUSE NUTRITION AND DIETETICS LLC NPI 1053222109

NPI Information

  • NPI: 1053222109
  • Provider Name: LIGHTHOUSE NUTRITION AND DIETETICS, LLC
  • Classification: Dietitian, Registered - 133VN1006X
  • Specialization: Nutrition, Metabolic
  • Entity Type: Organization
  • Address: 3689 MOULTRIE AVE
    SAN DIEGO, CA
    ZIP 92117
  • Phone: (619) 416-1771

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NPI Details

LIGHTHOUSE NUTRITION AND DIETETICS, LLC is a nutrition and metabolic dietitian registered in San Diego, CA. The provider is a registered dietitian who achieves specialized competency in metabolic nutrition. LIGHTHOUSE NUTRITION AND DIETETICS, LLC NPI is 1053222109. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

3689 MOULTRIE AVE
SAN DIEGO, CA
ZIP 92117-619
Phone: (619) 416-1771

The provider's authorized official is Eduardo Miguel Mendez .
The authorized official title is Registered Dietitian and has the following contact phone number (619) 416-1771.

The enumeration date for this NPI number is 9/16/2026 and was last updated on 9/16/2026.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1133VN1006XDietitian, RegisteredNutrition, MetabolicYes

What is NPI?

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This page was last updated on: 11/21/2025

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