Provider Demographics
NPI:1376639823
Name:BOST, FREDERIC (MD)
Entity Type:Individual
Prefix:
First Name:FREDERIC
Middle Name:
Last Name:BOST
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 1:3838 CALIFORNIA ST
Mailing Address - Street 2:SUITE 715
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94118-1522
Mailing Address - Country:US
Mailing Address - Phone:415-592-2014
Mailing Address - Fax:415-752-2560
Practice Address - Street 1:3838 CALIFORNIA ST
Practice Address - Street 2:SUITE 715
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94118-1522
Practice Address - Country:US
Practice Address - Phone:415-592-2014
Practice Address - Fax:415-752-2560
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2009-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG12889207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAYYY48586YMedicare ID - Type Unspecified
CAA89177Medicare UPIN