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Individual

MRS. ANNA MARGARITA SANTOS FOGLE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
L.V.N.

Contact information

Practice address
2292 PEACH TREE LN, SPRING VALLEY, CA 91977-7046
(619) 254-7244
Mailing address
7696 FLANDERS DR, SAN DIEGO, CA 92126-3063
(619) 254-7244

Taxonomy

Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
211484
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
RVN004090
MEDI-CAL PROVIDER
CA
Enumeration date
10/25/2006
Last updated
07/08/2007
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