Organization
CIRCLE OF LIFE MEDICINE, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEANNETTE I FREI M.D. (OWNER)
(916) 691-6622
Entity
Organization
Contact information
Practice address
2382 MARITIME DR, #100, ELK GROVE, CA 95758-3639
(916) 691-6622
(916) 691-6629
Mailing address
2382 MARITIME DR, #100, ELK GROVE, CA 95758-3639
(916) 691-6622
(916) 691-6629
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
A608670
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A608670
—
CA
Enumeration date
01/15/2009
Last updated
01/15/2009
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