Individual
DR. RUTH SUZANNE FONTAINE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D., M.A.
Contact information
Practice address
8879 LAUREL CANYON BLVD, SUITE C, SUN VALLEY, CA 91352-2959
(818) 252-2000
(818) 252-6896
Mailing address
3600 HARBOR BLVD, 80, OXNARD, CA 93035-4136
(805) 901-7644
(805) 985-3711
Taxonomy
Speciality
Code
Description
License number
State
2083P0500X
Preventive Medicine/Occupational Environmental Medicine Physician
A 41199
CA
2083P0901X
Public Health & General Preventive Medicine Physician
A41199
CA
208D00000X
General Practice Physician
Primary
A41199
CA
208VP0000X
Pain Medicine Physician
A 41199
CA
Other
Enumeration date
12/22/2006
Last updated
01/24/2011
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