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Individual

MRS. FONTAINE SADLAK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
3132 JEFFERSON ST, SAN DIEGO, CA 92110-4421
(760) 910-6217
Mailing address
3760 ULLA LN, LAKE ELSINORE, CA 92530-5341
(951) 907-7244

Taxonomy

Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
260620
CA

Other

Enumeration date
09/24/2011
Last updated
09/24/2011
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