Provider Demographics
NPI:1003121807
Name:NEUMANN, FREDERIC (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:FREDERIC
Middle Name:
Last Name:NEUMANN
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4707 STONEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:FAIRFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:94534-3927
Mailing Address - Country:US
Mailing Address - Phone:530-249-7464
Mailing Address - Fax:
Practice Address - Street 1:60 SOLANO SQ
Practice Address - Street 2:
Practice Address - City:BENICIA
Practice Address - State:CA
Practice Address - Zip Code:94510-2712
Practice Address - Country:US
Practice Address - Phone:707-746-0229
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-17
Last Update Date:2010-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA38664183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA38664OtherCALIFORNIA STATE BOARD OF PHARMACY