Individual
ADAM LEE FONVILLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3100 TELEGRAPH AVE STE 348, OAKLAND, CA 94609-3239
(707) 815-1086
Mailing address
3100 TELEGRAPH AVE STE 348, OAKLAND, CA 94609-3239
(707) 815-1086
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
95038418
CA
Other
Enumeration date
10/24/2022
Last updated
10/24/2022
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