MEDICARE: MARY SADLEK MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	A50552	CA

General Provider Information

NPI Number	:	1811981863
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARY SADLEK MD

Provider Business Mailing Address
First Line	:	PO BOX 28949
Second Line	:
City	:	FRESNO
State	:	CA
Zip	:	93729-8949
Country	:	US
Telephone Number	:	559-228-4200
Fax Number	:	559-224-3920

Provider Business Practice Location Address
First Line	:	5715 N WEST AVE
Second Line	:	SUITE 102
City	:	FRESNO
State	:	CA
Zip	:	93711-2366
Country	:	US
Telephone Number	:	559-438-0800
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/06/2005
Last Update Date	:	02/25/2020

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