Individual provider Active NPI

Anthony Medina, REGISTERED DIETITIAN

  • Obesity and Weight Management Nutrition Registered Dietitian
  • Huntington Beach, CA
National Provider Identifier
1700764545
Registry record updated Aug 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obesity and Weight Management Nutrition Registered DietitianTaxonomy code 133VN1201X
License
86331804 Issued in CA
Practice address
16531 Regina Cir Apt 3
Huntington Beach, CA 92649-3625
Phone
(562) 665-8196
NPI assigned
Aug 21, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Metabolic Nutrition Registered Dietitian 133VN1006X 86331804 CA
Gerontological Nutrition Registered Dietitian 133VN1101X 86331804 CA
Sports Dietetics Nutrition Registered Dietitian 133VN1501X 86331804 CA
Obesity and Weight Management Nutrition Registered Dietitian 133VN1201X 86331804 CA Primary

Addresses

Primary practice location

16531 Regina Cir Apt 3
Huntington Beach, CA 92649-3625

Mailing address

16531 Regina Cir Apt 3
Huntington Beach, CA 92649-3625
Phone (562) 665-8196

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
86331804CAMDMetabolic Nutrition Registered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Marjorie Nolan Cohn LLC Past Accepting new patients

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": "1755734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755734400000",
    "number": "1700764545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16531 REGINA CIR APT 3",
            "city": "HUNTINGTON BEACH",
            "state": "CA",
            "postal_code": "926493625",
            "telephone_number": "562-665-8196"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16531 REGINA CIR APT 3",
            "city": "HUNTINGTON BEACH",
            "state": "CA",
            "postal_code": "926493625",
            "telephone_number": "562-665-8196"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEDINA",
        "first_name": "ANTHONY",
        "credential": "REGISTERED DIETITIAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-08-21",
        "last_updated": "2025-08-21",
        "certification_date": "2025-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133VN1006X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered, Nutrition, Metabolic",
            "state": "CA",
            "license": "86331804",
            "primary": false
        },
        {
            "code": "133VN1101X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered, Nutrition, Gerontological",
            "state": "CA",
            "license": "86331804",
            "primary": false
        },
        {
            "code": "133VN1501X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered, Nutrition, Sports Dietetics",
            "state": "CA",
            "license": "86331804",
            "primary": false
        },
        {
            "code": "133VN1201X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered, Nutrition, Obesity and Weight Management",
            "state": "CA",
            "license": "86331804",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntington Beach, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2025; 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.