Individual
FREDRICK WILSON FONTELAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
957 INDUSTRIAL RD, SUITE B, SAN CARLOS, CA 94070-4151
(650) 832-6900
(650) 620-9549
Mailing address
957 INDUSTRIAL RD, SUITE B, SAN CARLOS, CA 94070-4151
(650) 832-6900
(650) 620-9549
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
09/08/2014
Last updated
12/22/2014
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