Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207V00000X | Obstetrician & Gynecologist | A94545 | CA |
Y | 207VF0040X | Female Pelvic Medicine and Reconstructive Surgeon | A94545 | CA |
NPI | 1104956408 |
---|---|
Provider Name | Anna Frick |
First Address | Mountain View, CA 94040-6203 |
Second Address | Oakland, CA 94609-3424 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/03/2007 |
Last Update Date | 22/02/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
A94545 | STATE MEDICAL LICENSE (01) | CA |
BF9729469 | FEDERAL DEA LICENSE (01) | CA |
RES000 | (02) | CA |