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General NPI Number Information
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NPI Number | 1831505809
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Entity Type | Individual
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Provider Name | FREDERICK CURTIS P.A.
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Gender | Male
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Dates
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Enumeration Date | 07/10/2014
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Last Update Date | 07/10/2014
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Provider Practice Location Address
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Address Line | 23500 KASSON RD
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City | TRACY
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State | CA
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Zip | 95378
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Country | US
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Telephone | 209-835-4141
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Fax |
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Provider Business Mailing Address
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Address Line | 1119 PACIFIC AVE
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City | ALAMEDA
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State | CA
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Zip | 94501-2227
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Country | US
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Telephone | 415-683-8514
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 22492
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License Number State | CA
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