Individual provider Active NPI

David Andrew Wiss, M.S., R.D.N

  • Registered Dietitian
  • Beverly Hills, CA
National Provider Identifier
1619353067
Registry record updated Aug 8, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
1089886 Issued in CA
Practice address
8549 Wilshire Blvd
Suite 646
Beverly Hills, CA 90211-3104
Phone
(310) 403-1874
Fax
(310) 470-7969
NPI assigned
Aug 8, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 8, 2015

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 1089886 CA Primary

Addresses

Primary practice location

8549 Wilshire Blvd
Suite 646
Beverly Hills, CA 90211-3104

Mailing address

2250 Parnell Ave
Los Angeles, CA 90064-2005
Phone (310) 403-1874

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
1089886CAMDRegistered Dietitian

NPI Registry JSON

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

{
    "created_epoch": "1438992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1438992000000",
    "number": "1619353067",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2250 PARNELL AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900642005",
            "telephone_number": "310-403-1874",
            "fax_number": "310-470-7969"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8549 WILSHIRE BLVD",
            "address_2": "SUITE 646",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "902113104",
            "telephone_number": "310-403-1874",
            "fax_number": "310-470-7969"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WISS",
        "first_name": "DAVID",
        "middle_name": "ANDREW",
        "name_prefix": "Mr.",
        "credential": "M.S., R.D.N",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-08-08",
        "last_updated": "2015-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "CA",
            "license": "1089886",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beverly Hills, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2015; 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.