Healthcare Provider Details

I. General information

NPI: 1376510321
Provider Name (Legal Business Name): ROBERT L. FREINKEL M.D., INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/08/2006
Last Update Date: 01/03/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1460 N CAMINO ALTO 109
VALLEJO CA
94589-2567
US

IV. Provider business mailing address

1460 N CAMINO ALTO 109
VALLEJO CA
94589-2567
US

V. Phone/Fax

Practice location:
  • Phone: 707-552-1262
  • Fax: 707-552-9599
Mailing address:
  • Phone: 707-552-1262
  • Fax: 707-552-9599

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207K00000X
TaxonomyAllergy & Immunology Physician
License Number00G253281
License Number StateCA

VIII. Authorized Official

Name: ROBERT LAWRENCE FREINKEL
Title or Position: DOCTOR
Credential: M.D.
Phone: 707-552-1262