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General NPI Number Information
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NPI Number | 1558535740
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Entity Type | Individual
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Provider Name | FREDERICK BARRY AXELROD MD
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Gender | Male
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Dates
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Enumeration Date | 04/17/2008
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Last Update Date | 04/17/2008
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Provider Practice Location Address
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Address Line | 384 W ORANGE SHOW RD BLOOD BANK OF SAN BERNARDINO AND RIVERSIDE COUNTIES
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City | SAN BERNARDINO
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State | CA
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Zip | 92408-2028
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Country | US
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Telephone | 909-885-6503
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Fax | 909-381-2036
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Provider Business Mailing Address
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Address Line | 384 W ORANGE SHOW RD BLOOD BANK OF SAN BERNARDINO AND RIVERSIDE COUNTIES
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City | SAN BERNARDINO
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State | CA
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Zip | 92408-2028
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Country | US
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Telephone | 909-885-6503
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Fax | 909-381-2036
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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 | 207ZP0105X
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Taxonomy Name | Clinical Pathology/Laboratory Medicine Physician
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License Number | G60047
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License Number State | CA
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