Provider Demographics
NPI:1417066416
Name:FRUMIN, FREDERICK M (MD)
Entity Type:Individual
Prefix:
First Name:FREDERICK
Middle Name:M
Last Name:FRUMIN
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 1:477 N EL CAMINO REAL STE B105
Mailing Address - Street 2:
Mailing Address - City:ENCINITAS
Mailing Address - State:CA
Mailing Address - Zip Code:92024-1330
Mailing Address - Country:US
Mailing Address - Phone:760-753-7143
Mailing Address - Fax:760-753-2155
Practice Address - Street 1:477 N EL CAMINO REAL STE B105
Practice Address - Street 2:
Practice Address - City:ENCINITAS
Practice Address - State:CA
Practice Address - Zip Code:92024-1330
Practice Address - Country:US
Practice Address - Phone:760-753-7143
Practice Address - Fax:760-753-2155
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG40662208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics