Healthcare Provider Details

I. General information

NPI: 1053124438
Provider Name (Legal Business Name): STEVEN FREUND
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/29/2025
Last Update Date: 07/22/2026
Certification Date: 07/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

NAVAL MEDICAL CENTER SAN DIEGO 34800 BOB WILSON DRIVE
SAN DIEGO CA
92134-5000
US

IV. Provider business mailing address

NAVAL MEDICAL CENTER SAN DIEGO 34800 BOB WILSON DRIVE
SAN DIEGO CA
92134-5000
US

V. Phone/Fax

Practice location:
  • Phone: 678-622-6155
  • Fax:
Mailing address:
  • Phone: 678-622-6155
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number0102210374
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: