Healthcare Provider Details

I. General information

NPI: 1942973839
Provider Name (Legal Business Name): FLORIAN FRUEH MD, PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/27/2021
Last Update Date: 07/27/2021
Certification Date: 07/27/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

45 CASTRO ST
SAN FRANCISCO CA
94114-1010
US

IV. Provider business mailing address

22A MUSEUM WAY
SAN FRANCISCO CA
94114-1428
US

V. Phone/Fax

Practice location:
  • Phone: 415-565-6136
  • Fax:
Mailing address:
  • Phone: 415-400-6600
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
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: