Provider Demographics
NPI:1184735573
Name:DAVID, LUCILLE SADLER (LAC)
Entity type:Individual
Prefix:MRS
First Name:LUCILLE
Middle Name:SADLER
Last Name:DAVID
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6861 E SEPTIMO ST
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90815-5019
Mailing Address - Country:US
Mailing Address - Phone:562-310-8132
Mailing Address - Fax:
Practice Address - Street 1:16630 S BROADWAY
Practice Address - Street 2:
Practice Address - City:GARDENA
Practice Address - State:CA
Practice Address - Zip Code:90248-2716
Practice Address - Country:US
Practice Address - Phone:310-768-8155
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2022-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC10538171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist