Fedoroff, Gary

Fedoroff, Gary is an individual health care provider with primary practice located at 171 Carlos Dr , San Rafael CA 94903-2005. He recently has only one registered license in Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), which is considered as his primary health care specialty. Fedoroff, Gary can be contacted via phone (415) 755-2310.

Contact Information

Primary practice address
171 Carlos Dr San Rafael CA 94903-2005
Phone: (415) 755-2310
Fax: (415) 755-2210
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X

Profile Details

NPI number 1093036717
LBN Legal business name Fedoroff, Gary
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 16th, 2010
Last updated Jun 16th, 2010 - about 14 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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