Individual provider Active NPI

Dalia Siada Beydoun, RD

  • Registered Dietitian
  • Costa Mesa, CA
National Provider Identifier
1356954283
Registry record updated Aug 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
86010806 Issued in CA
Practice address
3100 Airway Ave Ste 139
Costa Mesa, CA 92626-4614
Phone
(949) 409-5676
NPI assigned
Aug 29, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 30, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 86010806 CA Primary

Addresses

Primary practice location

3100 Airway Ave Ste 139
Costa Mesa, CA 92626-4614

Mailing address

3843 S Bristol St # 175
Santa Ana, CA 92704-7426
Phone (559) 301-7314

Other practice location 1

200 W Arbor Dr
San Diego, CA 92103-9000
Phone (949) 409-5676

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
86010806CAMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
DSB Nutrition LLC Dietitian, Registered CurrentSince Sep 5, 2023 Accepting new patients

Locations

3100 Airway Ave
Ste 139
Costa Mesa, CA 92626
Phone (949) 334-7237

3843 S Bristol St
Santa Ana, CA 92704
Phone (714) 210-2450

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1598659200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693353600000",
    "number": "1356954283",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3843 S BRISTOL ST # 175",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927047426",
            "telephone_number": "559-301-7314"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3100 AIRWAY AVE STE 139",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926264614",
            "telephone_number": "949-409-5676"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "200 W Arbor Dr",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921039000",
            "country_code": "US",
            "telephone_number": "949-409-5676",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BEYDOUN",
        "first_name": "DALIA",
        "middle_name": "SIADA",
        "credential": "RD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-29",
        "last_updated": "2023-08-30",
        "certification_date": "2023-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "CA",
            "license": "86010806",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Costa Mesa, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2023; 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.