Provider Demographics
NPI:1245207489
Name:FREINKEL, ROBERT LAWRENCE (MD)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:LAWRENCE
Last Name:FREINKEL
Suffix:
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 1:1460 N CAMINO ALTO
Mailing Address - Street 2:
Mailing Address - City:VALLEJO
Mailing Address - State:CA
Mailing Address - Zip Code:94589-2567
Mailing Address - Country:US
Mailing Address - Phone:707-552-1262
Mailing Address - Fax:707-552-9599
Practice Address - Street 1:1460 N CAMINO ALTO
Practice Address - Street 2:
Practice Address - City:VALLEJO
Practice Address - State:CA
Practice Address - Zip Code:94589-2567
Practice Address - Country:US
Practice Address - Phone:707-552-1262
Practice Address - Fax:707-552-9599
Is Sole Proprietor?:No
Enumeration Date:2006-03-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA00G253281207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G253281OtherBLUE SHIELD
CA00G253281Medicaid
CA00G253281OtherBLUE CROSS
CA00G253281Medicaid
CAA42623Medicare UPIN