MEDICARE: DR. MARLENE H FREEMAN 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
1	207V00000X	Obstetrics & Gynecology Physician	G87122	CA

General Provider Information

NPI Number	:	1811960966
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARLENE H FREEMAN M.D.

Provider Business Mailing Address
First Line	:	10470 OLD PLACERVILLE RD
Second Line	:	SUITE 100
City	:	SACRAMENTO
State	:	CA
Zip	:	95827-2539
Country	:	US
Telephone Number	:	800-470-0071
Fax Number	:

Provider Business Practice Location Address
First Line	:	2702 LOW CT
Second Line	:	DEPT OF OB/GYN
City	:	FAIRFIELD
State	:	CA
Zip	:	94534-9771
Country	:	US
Telephone Number	:	707-432-2810
Fax Number	:	707-432-2800

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/09/2006
Last Update Date	:	07/27/2015

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