Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Q00000X | Family Doctor | 20A11771 | CA |
Y | 207QH0002X | Family Doctor - Hospice and Palliative Medicine | 20A 11771 | CA |
NPI | 1619137064 |
---|---|
Provider Name | Joshua C Fronk |
First Address | Stanford, CA 94305-5102 |
Second Address | Stanford, CA 94305-2200 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/06/2008 |
Last Update Date | 29/11/2021 |