Healthcare Provider Details

I. General information

NPI: 1104956408
Provider Name (Legal Business Name): ANNA FRICK MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/06/2007
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

350 30TH ST SUITE 100
OAKLAND CA
94609-3424
US

IV. Provider business mailing address

2350 W EL CAMINO REAL FL 2
MOUNTAIN VIEW CA
94040-6203
US

V. Phone/Fax

Practice location:
  • Phone: 510-204-1844
  • Fax:
Mailing address:
  • Phone: 510-204-1844
  • Fax: 510-273-8977

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberA94545
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code207VF0040X
TaxonomyUrogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
License NumberA94545
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: