Active NPI
Lighthouse Nutrition and Dietetics, LLC
- Metabolic Nutrition Registered Dietitian
- San Diego, CA
National Provider Identifier
1053222109
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Metabolic Nutrition Registered Dietitian
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Eduardo Miguel Mendez, RD, MPH
- 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) | Code | License | State | Primary |
|---|---|---|---|---|
| Metabolic Nutrition Registered Dietitian | 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 DirectoryPractitioners & 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.
-
- Registered Dietitian
- San Diego, CA
- NPI 1164397543
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
- Cyril S Light, M.D.
- Lightbridge Hospice, LLC (Lightbridge Hospice)
- Lightbridge Medical Associates, Inc.
- Catrissa Laverne Lightfoot-Siordia, M.D., MHA
- Christine Maria Lightfoot, MD
- Lighthouse Psychological Services
- Lighthouse Psychological Services, Inc
- Lighthouse Treatment, Inc
- Mordecai Shalom Lightman, DDS
- Chloe Lightner, DC
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.