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General NPI Number Information
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NPI Number | 1013017268
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Entity Type | Individual
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Provider Name | ASANO FLOY FERTIG MD
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Gender | Female
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Dates
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Enumeration Date | 09/25/2006
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Last Update Date | 11/23/2007
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Provider Practice Location Address
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Address Line | 1515 FRUITVALE AVE
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City | OAKLAND
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State | CA
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Zip | 94601-2322
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Country | US
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Telephone | 510-535-6300
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Fax | 510-535-5802
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Provider Business Mailing Address
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Address Line | 1601 FRUITVALE AVE
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City | OAKLAND
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State | CA
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Zip | 94601-2322
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Country | US
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Telephone | 510-535-4000
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Fax | 510-535-4128
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | G52878
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License Number State | CA
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