Healthcare Provider Details

I. General information

NPI: 1427686807
Provider Name (Legal Business Name): GRACE ELIZABETH FRITTS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: GRACE CHEN

II. Dates (important events)

Enumeration Date: 03/31/2020
Last Update Date: 09/08/2026
Certification Date: 09/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

26672 PORTOLA PKWY STE 108
FOOTHILL RANCH CA
92610-1773
US

IV. Provider business mailing address

2995 RED HILL AVE STE 200
COSTA MESA CA
92626-5984
US

V. Phone/Fax

Practice location:
  • Phone: 949-829-5533
  • Fax: 949-581-9158
Mailing address:
  • Phone: 949-829-5533
  • Fax: 949-581-9158

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number4301511499
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: