Fredrick, Mark J.

Fredrick, Mark J. is an individual health care provider with primary practice located at 19066 Magnolia St , Huntington Beach CA 92646. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Fredrick, Mark J. can be contacted via phone (714) 968-0068.

Contact Information

Primary practice address
19066 Magnolia St Huntington Beach CA 92646
Phone: (714) 968-0068
Fax: (714) 378-2188
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X G67380 California

Profile Details

NPI number 1518964998
LBN Legal business name Fredrick, Mark J.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 30th, 2005
Last updated Oct 16th, 2012 - about 12 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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Identifiers

StateTypeNumberIssuer
All States NPI 1518964998 NPPES
California Other 00G673800 MEDI CAL

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