Provider Demographics
NPI:1912934779
Name:FREY, ROBERT D (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:D
Last Name:FREY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1280 S VICTORIA AVE STE 204
Mailing Address - Street 2:
Mailing Address - City:VENTURA
Mailing Address - State:CA
Mailing Address - Zip Code:93003-6551
Mailing Address - Country:US
Mailing Address - Phone:805-644-4930
Mailing Address - Fax:805-654-1284
Practice Address - Street 1:1752 S VICTORIA AVE
Practice Address - Street 2:SUITE B
Practice Address - City:VENTURA
Practice Address - State:CA
Practice Address - Zip Code:93003-6192
Practice Address - Country:US
Practice Address - Phone:805-644-4930
Practice Address - Fax:805-654-1284
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-27
Last Update Date:2023-12-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA85317207LP2900X, 208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
No207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAWA85317AMedicare ID - Type Unspecified