Healthcare Provider Details

I. General information

NPI: 1629246798
Provider Name (Legal Business Name): DEBORAH JUNE FREEHLING MEDICAL DOCTOR
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/12/2008
Last Update Date: 12/14/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2204 GRANT ROAD SUITE 102
MOUNTAIN VIEW CA
94040
US

IV. Provider business mailing address

2204 GRANT ROAD SUITE 102
MOUNTAIN VIEW CA
94040
US

V. Phone/Fax

Practice location:
  • Phone: 650-969-2270
  • Fax: 650-962-9889
Mailing address:
  • Phone: 650-969-2270
  • Fax: 650-962-9889

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License NumberG48337
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code207YX0007X
TaxonomyPlastic Surgery within the Head & Neck (Otolaryngology) Physician
License NumberG48337
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code207YX0602X
TaxonomyOtolaryngic Allergy Physician
License NumberG48337
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: