Provider Demographics
NPI:1346382546
Name:CORDOVA, BETH ELISE (MPA, RDN)
Entity type:Individual
Prefix:
First Name:BETH
Middle Name:ELISE
Last Name:CORDOVA
Suffix:
Gender:F
Credentials:MPA, RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1211 PENDIO
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92620-1751
Mailing Address - Country:US
Mailing Address - Phone:949-363-3674
Mailing Address - Fax:
Practice Address - Street 1:1211 PENDIO
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92620-1751
Practice Address - Country:US
Practice Address - Phone:949-363-3674
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-13
Last Update Date:2025-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered