Healthcare Provider Details

I. General information

NPI: 1902996069
Provider Name (Legal Business Name): FREDERICK HOPKINS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/12/2006
Last Update Date: 03/13/2023
Certification Date: 03/13/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2365 MONTPELIER DR
SAN JOSE CA
95116-1614
US

IV. Provider business mailing address

1834 STONE AVE SUITE 2B
SAN JOSE CA
95125-1306
US

V. Phone/Fax

Practice location:
  • Phone: 408-272-9244
  • Fax: 408-254-4596
Mailing address:
  • Phone: 408-995-0102
  • Fax: 408-995-0190

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberMD2004-0169
License Number StateNM
# 2
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberDR.0065091
License Number StateCO
# 3
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberG84697
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: