Individual
FREDERICK CHARLES DAVID
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3555 ROUND BARN CIRCLE, SANTA ROSA, CA 95403-1757
(707) 528-1050
(707) 576-0445
Mailing address
3555 ROUND BARN CIRCLE, SANTA ROSA, CA 95403-1757
(707) 528-1050
(707) 576-0445
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
G34598
CA
2085R0203X
Therapeutic Radiology Physician
G34598
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G345980
—
CA
Enumeration date
10/11/2006
Last updated
10/21/2021
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