| Doctor Name: | DR. NADINE ELAINE SIDRICK |
| NPI Number: | 1134140718 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | M.D. |
| License Number: | G42131 |
| Business Practice Address: | 5602 El Cajon Blvd San Diego, CA - 921153735 |
| Business Phone Number: | 6195825105 |
| Business Fax Number: | 6195825121 |
| Mailing Address: | 3089 Clairemont Dr Ste C Pmb 510, SAN DIEGO |
| State: | CA |
| Postal Code: | 921176892 |
| Phone Number: | 6195825105 |
| Fax Number: | 6195825121 |
| NPI Enumeration Date: | 07/21/2006 |
| NPI Last Update Date: | 01/04/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | G42131 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |