Individual
DR. ADAM RANDALL FREDERICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1808 VERDUGO BLVD, STE. 305, GLENDALE, CA 91208-1477
(818) 790-1103
(818) 949-4981
Mailing address
1808 VERDUGO BLVD, STE. 305, GLENDALE, CA 91208-1477
(818) 790-1103
(818) 949-4981
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
6825146-1205
UT
207Q00000X
Family Medicine Physician
Primary
A109537
CA
Other
Enumeration date
12/29/2007
Last updated
03/27/2013
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