Organization Active NPI

Lighthouse Nutrition and Dietetics, LLC

  • Metabolic Nutrition Registered Dietitian
  • San Diego, CA
National Provider Identifier
1053222109
Registry record updated Sep 16, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Metabolic Nutrition Registered DietitianTaxonomy code 133VN1006X
Legal business name
LIGHTHOUSE NUTRITION AND DIETETICS, LLC
Practice address
3689 Moultrie Ave
San Diego, CA 92117-5619
Phone
(619) 416-1771
NPI assigned
Sep 16, 2026
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Eduardo Miguel Mendez, RD, MPHNPI 1164397543
Title
Registered Dietitian
Phone
(619) 416-1771

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Metabolic Nutrition Registered DietitianGroup: 193400000X SINGLE SPECIALTY GROUP 133VN1006X Primary

Addresses

Primary practice location

3689 Moultrie Ave
San Diego, CA 92117-5619

Mailing address

3689 Moultrie Ave
San Diego, CA 92117-5619
Phone (619) 416-1771

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1789516800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1789516800000",
    "number": "1053222109",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3689 MOULTRIE AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921175619",
            "telephone_number": "619-416-1771"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3689 MOULTRIE AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921175619",
            "telephone_number": "619-416-1771"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIGHTHOUSE NUTRITION AND DIETETICS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-09-16",
        "last_updated": "2026-09-16",
        "certification_date": "2026-09-16",
        "status": "A",
        "authorized_official_last_name": "MENDEZ",
        "authorized_official_first_name": "EDUARDO",
        "authorized_official_middle_name": "MIGUEL",
        "authorized_official_title_or_position": "REGISTERED DIETITIAN",
        "authorized_official_telephone_number": "619-416-1771",
        "authorized_official_credential": "RD, MPH"
    },
    "taxonomies": [
        {
            "code": "133VN1006X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dietitian, Registered, Nutrition, Metabolic",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.