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General NPI Number Information
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NPI Number | 1457533192
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Entity Type | Individual
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Provider Name | ALAN JOSEPH FRUEH M.D.
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Gender | Male
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Dates
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Enumeration Date | 12/05/2007
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Last Update Date | 12/05/2007
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Provider Practice Location Address
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Address Line | 501 J. STREET, SUITE 200
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City | SACRAMENTO
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State | CA
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Zip | 94283
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Country | US
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Telephone | 916-212-4923
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Fax |
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Provider Business Mailing Address
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Address Line | P.O. BOX 94283 DIVISION OF CORRECTIONAL HEALTHCARE SERVICE
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City | SACRAMENTO
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State | CA
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Zip | 94283
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Country | US
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Telephone | 916-212-4923
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | G27635
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License Number State | CA
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