Provider Demographics
NPI:1013009679
Name:PITTS, FREDERICK D JR (MD)
Entity Type:Individual
Prefix:
First Name:FREDERICK
Middle Name:D
Last Name:PITTS
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:229 7TH ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94103-4003
Mailing Address - Country:US
Mailing Address - Phone:415-503-6042
Mailing Address - Fax:415-503-6099
Practice Address - Street 1:229 7TH ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94103-4003
Practice Address - Country:US
Practice Address - Phone:415-503-6042
Practice Address - Fax:415-503-6099
Is Sole Proprietor?:No
Enumeration Date:2006-09-29
Last Update Date:2013-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG84061207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G840610Medicaid
G84061Medicare UPIN
CA00G840610Medicaid