Provider Demographics
NPI:1942419106
Name:FRIEDERICHS, TIMOTHY WILLIAM (MD)
Entity Type:Individual
Prefix:DR
First Name:TIMOTHY
Middle Name:WILLIAM
Last Name:FRIEDERICHS
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:17577 CROSS RD
Mailing Address - Street 2:
Mailing Address - City:SALINAS
Mailing Address - State:CA
Mailing Address - Zip Code:93907-1501
Mailing Address - Country:US
Mailing Address - Phone:831-663-2675
Mailing Address - Fax:831-678-5907
Practice Address - Street 1:CORRECTIONAL TRAINING FACILITY
Practice Address - Street 2:HIGHWAY 101, 4 MILES NORTH OF SOLEDAD
Practice Address - City:SOLEDAD
Practice Address - State:CA
Practice Address - Zip Code:93960-9529
Practice Address - Country:US
Practice Address - Phone:831-678-3951
Practice Address - Fax:831-678-5907
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-22
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAG39073207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine