Provider Demographics
NPI:1689667495
Name:BREDEEK MENDES, ULF FRITZ (MD, PHD)
Entity Type:Individual
Prefix:DR
First Name:ULF FRITZ
Middle Name:
Last Name:BREDEEK MENDES
Suffix:
Gender:M
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3400 DATA DR
Mailing Address - Street 2:
Mailing Address - City:RANCHO CORDOVA
Mailing Address - State:CA
Mailing Address - Zip Code:95670-7956
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2900 WHIPPLE AVE STE 132
Practice Address - Street 2:
Practice Address - City:REDWOOD CITY
Practice Address - State:CA
Practice Address - Zip Code:94062-2844
Practice Address - Country:US
Practice Address - Phone:650-817-2117
Practice Address - Fax:650-817-2119
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-26
Last Update Date:2023-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA31728207RI0200X, 207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ791055Medicaid
AZ791055Medicaid
AZH87968Medicare UPIN
AZ75413Medicare ID - Type Unspecified