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General NPI Number Information
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NPI Number | 1174589253
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Entity Type | Individual
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Provider Name | PATRICK ALFRED FITZGERALD ATC
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Gender | Male
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Dates
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Enumeration Date | 04/26/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1700 W HILLSDALE BLVD
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City | SAN MATEO
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State | CA
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Zip | 94402-3757
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Country | US
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Telephone | 650-574-6451
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Fax | 650-574-6518
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Provider Business Mailing Address
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Address Line | 226 JACKSON AVE
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City | REDWOOD CITY
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State | CA
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Zip | 94061-1631
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Country | US
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Telephone | 650-368-8654
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Fax | 650-368-0903
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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