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General NPI Number Information
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NPI Number | 1336609445
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Entity Type | Individual
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Provider Name | GABRIEL FREGOSO MD
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Gender | Male
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Dates
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Enumeration Date | 03/23/2019
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Last Update Date | 08/08/2024
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Provider Practice Location Address
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Address Line | 4150 V ST
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City | SACRAMENTO
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State | CA
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Zip | 95817-1460
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Country | US
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Telephone | 805-861-4663
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Fax |
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Provider Business Mailing Address
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Address Line | 4150 V ST
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City | SACRAMENTO
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State | CA
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Zip | 95817-1460
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Country | US
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Telephone |
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Fax |
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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 | 207LC0200X
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Taxonomy Name | Critical Care Medicine (Anesthesiology) Physician
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License Number | 295587
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 207LC0200X
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Taxonomy Name | Critical Care Medicine (Anesthesiology) Physician
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License Number | A192772
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License Number State | CA
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