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NPI Code Detail

MEDICARE: ANTHONY E FRYE

MEDICARE: ANTHONY E FRYE
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
1101YA0400XAddiction (Substance Use Disorder) CounselorRI-F0509300745CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
14881OTHERCASIMON STAFF NUMBER

General Provider Information

NPI Number : 1194935270
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANTHONY E FRYE
Provider Business Mailing Address
First Line : 40925 COUNTY CENTER DR STE 100&200
Second Line :
City : TEMECULA
State : CA
Zip : 92591-6054
Country : US
Telephone Number : 951-600-6360
Fax Number :
Provider Business Practice Location Address
First Line : 7885 ANNANDALE AVE
Second Line :
City : DESERT HOT SPRINGS
State : CA
Zip : 92240-1419
Country : US
Telephone Number : 760-329-2924
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/23/2007
Last Update Date : 06/27/2023

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Directions to “ ANTHONY E FRYE ” Practice Location

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