Individual
CHARLES FREDERICKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2315 STOCKTON BLVD, SACRAMENTO, CA 95817-2201
(916) 734-5638
Mailing address
531 GRAPE ST, HAMMONTON, NJ 08037-1654
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
125-063161
IL
208600000X
Surgery Physician
Primary
A161492
CA
Other
Enumeration date
05/21/2013
Last updated
06/25/2019
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