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NPI Code Detail

MEDICARE: DR. FREDERICK CONRAD LI M.D.

MEDICARE: DR. FREDERICK CONRAD LI M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207LP2900XPain Medicine (Anesthesiology) PhysicianA168284CA

General Provider Information

NPI Number : 1013362391
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. FREDERICK CONRAD LI M.D.
Provider Business Mailing Address
First Line : 440 N BARRANCA AVE # 2318
Second Line :
City : COVINA
State : CA
Zip : 91723-1722
Country : US
Telephone Number : 832-622-6212
Fax Number : 832-622-6212
Provider Business Practice Location Address
First Line : 757 WESTWOOD PLZ STE 3325
Second Line :
City : LOS ANGELES
State : CA
Zip : 90095-7419
Country : US
Telephone Number : 310-794-4494
Fax Number : 310-267-3899
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/25/2016
Last Update Date : 08/25/2025

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