Provider Demographics
NPI:1851460505
Name:ASCHE, FREDERICK GRAY (MD)
Entity Type:Individual
Prefix:
First Name:FREDERICK
Middle Name:GRAY
Last Name:ASCHE
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:PO BOX 2462
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92859-0462
Mailing Address - Country:US
Mailing Address - Phone:562-933-0085
Mailing Address - Fax:562-933-0088
Practice Address - Street 1:1720 TERMINO AVENUE
Practice Address - Street 2:MEMORIAL OCCUPATIONAL MEDICAL SERVICES
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90804
Practice Address - Country:US
Practice Address - Phone:562-933-0085
Practice Address - Fax:562-933-0088
Is Sole Proprietor?:No
Enumeration Date:2006-11-07
Last Update Date:2013-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG290512083X0100X
WI190802083X0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG29051OtherCALIFORNIA MED. LICENSE