Provider Demographics
NPI:1497943112
Name:FRADET, VINCENT (MD)
Entity Type:Individual
Prefix:DR
First Name:VINCENT
Middle Name:
Last Name:FRADET
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:1600 DIVISADERO ST
Mailing Address - Street 2:ROOM A629
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94115-1695
Mailing Address - Country:US
Mailing Address - Phone:415-885-3679
Mailing Address - Fax:415-885-7443
Practice Address - Street 1:1600 DIVISADERO ST
Practice Address - Street 2:ROOM A629
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94115-3010
Practice Address - Country:US
Practice Address - Phone:415-885-3679
Practice Address - Fax:415-885-7443
Is Sole Proprietor?:No
Enumeration Date:2007-10-09
Last Update Date:2007-10-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA101581208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology