Provider Demographics
NPI:1104867753
Name:FRISCHER MEDICAL GROUP
Entity Type:Organization
Organization Name:FRISCHER MEDICAL GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:TRUDY
Authorized Official - Middle Name:L
Authorized Official - Last Name:GARCIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:562-806-0874
Mailing Address - Street 1:11480 BROOKSHIRE AVE
Mailing Address - Street 2:200
Mailing Address - City:DOWNEY
Mailing Address - State:CA
Mailing Address - Zip Code:90241-5010
Mailing Address - Country:US
Mailing Address - Phone:562-806-0874
Mailing Address - Fax:562-927-4801
Practice Address - Street 1:11480 BROOKSHIRE AVE
Practice Address - Street 2:200
Practice Address - City:DOWNEY
Practice Address - State:CA
Practice Address - Zip Code:90241-5010
Practice Address - Country:US
Practice Address - Phone:562-806-0874
Practice Address - Fax:562-927-4801
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA42471207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAE69149Medicare UPIN
CAW14059Medicare ID - Type UnspecifiedFRISCHER MEDICAL GROUP