Provider Demographics
NPI:1629554415
Name:BARTON, FREDERICK STROTHER III (PHARMD)
Entity Type:Individual
Prefix:
First Name:FREDERICK
Middle Name:STROTHER
Last Name:BARTON
Suffix:III
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:179 CAMINO PABLO
Mailing Address - Street 2:
Mailing Address - City:ORINDA
Mailing Address - State:CA
Mailing Address - Zip Code:94563-2220
Mailing Address - Country:US
Mailing Address - Phone:502-609-2387
Mailing Address - Fax:
Practice Address - Street 1:910 DIABLO AVE
Practice Address - Street 2:
Practice Address - City:NOVATO
Practice Address - State:CA
Practice Address - Zip Code:94947-7311
Practice Address - Country:US
Practice Address - Phone:415-898-1905
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-14
Last Update Date:2018-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY015924183500000X
CA78532183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist