Individual
JOSEPH ERNEST FANT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LVN
Contact information
Practice address
7484 SKYLINE DR, SAN DIEGO, CA 92114-4621
(858) 688-3840
(760) 317-2234
Mailing address
7484 SKYLINE DR, SAN DIEGO, CA 92114-4621
(858) 688-3840
(760) 317-2234
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
164209
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
RVN000500
—
CA
Enumeration date
02/15/2007
Last updated
01/15/2013
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