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General NPI Number Information
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NPI Number | 1326083213
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Entity Type | Individual
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Provider Name | FREDERICK S DRACH M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/17/2006
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Last Update Date | 01/25/2021
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Provider Practice Location Address
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Address Line | 500 DOYLE PARK DR SUITE 106A
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City | SANTA ROSA
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State | CA
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Zip | 95405-4558
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Country | US
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Telephone | 707-303-8309
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Fax | 707-303-1087
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Provider Business Mailing Address
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Address Line | 500 DOYLE PARK DR SUITE 106A
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City | SANTA ROSA
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State | CA
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Zip | 95405-4558
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Country | US
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Telephone | 707-303-8309
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Fax | 707-303-1087
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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 | 207RI0200X
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Taxonomy Name | Infectious Disease Physician
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License Number | G46960
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License Number State | CA
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