Provider Demographics
NPI:1700999844
Name:FREDIAN, APRIL (MD)
Entity Type:Individual
Prefix:DR
First Name:APRIL
Middle Name:
Last Name:FREDIAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:450 PARK ST
Mailing Address - Street 2:SUITE 100B
Mailing Address - City:ALAMEDA
Mailing Address - State:CA
Mailing Address - Zip Code:94501-6295
Mailing Address - Country:US
Mailing Address - Phone:510-992-3104
Mailing Address - Fax:510-227-6890
Practice Address - Street 1:450 PARK ST
Practice Address - Street 2:SUITE 100B
Practice Address - City:ALAMEDA
Practice Address - State:CA
Practice Address - Zip Code:94501-6295
Practice Address - Country:US
Practice Address - Phone:510-992-3104
Practice Address - Fax:510-227-6890
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-15
Last Update Date:2014-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA108550207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACA119494OtherMEDICARE PTAN