Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YS0123X | Facial Plastic Surgeon | 156538 | CA |
NPI | 1710229893 |
---|---|
Provider Name | Dr. Zachary Calnan Fridirici |
First Address | San Francisco, CA 94115-3470 |
Second Address | San Francisco, CA 94115 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/03/2013 |
Last Update Date | 29/06/2018 |