Individual
LUC OCTAVE FONTAINE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D
Contact information
Practice address
233 W COLE BLVD, CALEXICO, CA 92231-9722
(760) 357-2020
(760) 357-1056
Mailing address
233 W COLE BLVD, CALEXICO, CA 92231-9722
(760) 357-2020
(760) 357-1056
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
A36515
CA
Other
Enumeration date
07/07/2006
Last updated
03/14/2016
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