Provider Demographics
NPI:1609041425
Name:FREDA L. DREHER, MEDICAL PROFESSIONAL CORPORATION
Entity Type:Organization
Organization Name:FREDA L. DREHER, MEDICAL PROFESSIONAL CORPORATION
Other - Org Name:ALTOS MEDICAL ACUPUNCTURE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:FREDA
Authorized Official - Middle Name:L
Authorized Official - Last Name:DREHER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:650-949-4325
Mailing Address - Street 1:1000 FREMONT AVE STE 152
Mailing Address - Street 2:
Mailing Address - City:LOS ALTOS
Mailing Address - State:CA
Mailing Address - Zip Code:94024-6057
Mailing Address - Country:US
Mailing Address - Phone:650-949-4325
Mailing Address - Fax:650-949-4325
Practice Address - Street 1:1000 FREMONT AVE STE 152
Practice Address - Street 2:
Practice Address - City:LOS ALTOS
Practice Address - State:CA
Practice Address - Zip Code:94024-6057
Practice Address - Country:US
Practice Address - Phone:650-949-4325
Practice Address - Fax:650-949-4325
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-23
Last Update Date:2009-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG080462208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty