Healthcare Provider Details

I. General information

NPI: 1457557910
Provider Name (Legal Business Name): ERIC S FRECHETTE M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: ERIC PETER SHRADER-FRECHETTE

II. Dates (important events)

Enumeration Date: 06/22/2007
Last Update Date: 07/04/2025
Certification Date: 07/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

622 W DUARTE RD STE 304
ARCADIA CA
91007-9280
US

IV. Provider business mailing address

622 W DUARTE RD STE 304
ARCADIA CA
91007-9280
US

V. Phone/Fax

Practice location:
  • Phone: 626-737-6231
  • Fax: 855-515-1574
Mailing address:
  • Phone: 626-737-6231
  • Fax: 855-515-1574

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084E0001X
TaxonomyEpilepsy Physician
License NumberA117118
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code2084N0600X
TaxonomyClinical Neurophysiology Physician
License NumberA117118
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License NumberA117118
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: