Provider Demographics
NPI:1376510321
Name:ROBERT L. FREINKEL M.D., INC
Entity Type:Organization
Organization Name:ROBERT L. FREINKEL M.D., INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:LAWRENCE
Authorized Official - Last Name:FREINKEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:707-552-1262
Mailing Address - Street 1:1460 N CAMINO ALTO
Mailing Address - Street 2:109
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 2:109
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
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-08
Last Update Date:2011-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA00G253281207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G253281OtherBLUE CROSS
CA00G253281OtherBLUE SHIELD
CA00G253281Medicaid
CA00G253281Medicare ID - Type Unspecified
CAA42623Medicare UPIN