Provider Demographics
NPI:1134318785
Name:SADOWSKY, GLENN DAVID (L AC)
Entity Type:Individual
Prefix:MR
First Name:GLENN
Middle Name:DAVID
Last Name:SADOWSKY
Suffix:
Gender:M
Credentials:L AC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:132 CARMELITO AVE
Mailing Address - Street 2:
Mailing Address - City:MONTEREY
Mailing Address - State:CA
Mailing Address - Zip Code:93940-4502
Mailing Address - Country:US
Mailing Address - Phone:831-655-3208
Mailing Address - Fax:831-655-3208
Practice Address - Street 1:132 CARMELITO AVE
Practice Address - Street 2:
Practice Address - City:MONTEREY
Practice Address - State:CA
Practice Address - Zip Code:93940-4502
Practice Address - Country:US
Practice Address - Phone:831-655-3208
Practice Address - Fax:831-655-3208
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-19
Last Update Date:2007-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA8923171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist