Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207K00000X | Allergist & Immunologist | 00G253281 | CA |
NPI | 1245207489 |
---|---|
Provider Name | Robert Lawrence Freinkel |
First Address | Vallejo, CA 94589-2567 |
Second Address | Vallejo, CA 94589-2567 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/03/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00G253281 | (05) | CA |
00G253281 | BLUE CROSS (01) | CA |
00G253281 | BLUE SHIELD (01) | CA |
A42623 | (02) | CA |