Healthcare Provider Details

I. General information

NPI: 1174507347
Provider Name (Legal Business Name): RICHARD DALE FRISHMAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/01/2005
Last Update Date: 05/11/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2100 NAPA VALLEJO HWY
NAPA CA
94558-6234
US

IV. Provider business mailing address

1688 MILTON RD
NAPA CA
94559-9772
US

V. Phone/Fax

Practice location:
  • Phone: 707-253-5405
  • Fax:
Mailing address:
  • Phone: 530-210-5844
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberA054270
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number5494
License Number StateAK
# 3
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number7405
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: