Healthcare Provider Details

I. General information

NPI: 1831197789
Provider Name (Legal Business Name): FREDERICK CHARLES ARBENZ M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/13/2005
Last Update Date: 07/30/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1441 W STATE ST SUITE B
EL CENTRO CA
92243-2800
US

IV. Provider business mailing address

1441 W STATE ST SUITE B
EL CENTRO CA
92243-2800
US

V. Phone/Fax

Practice location:
  • Phone: 760-337-1771
  • Fax: 760-337-1122
Mailing address:
  • Phone: 760-337-1771
  • Fax: 760-337-1122

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License NumberG55316
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: