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DR. DOUGLAS R. FREDRICK MD NPI 1053366633


NPI Information

NPI: 1053366633
Provider Name: DR. DOUGLAS R. FREDRICK, MD
Classification: Ophthalmology - 207WX0110X
Entity Type: Individual

Specialization: Pediatric Ophthalmology and Strabismus Specialist

PECOS Registration: Yes

Address:
395 HICKEY BLVD
DALY CITY, CA
ZIP 94015
Phone: (650) 742-2000
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DR. Douglas R. Fredrick, MD is a pediatric ophthalmology and strabismus specialist ophthalmology in Daly City, CA. The provider is an ophthalmologist who specializes in pediatric ophthalmology and strabismus management. The subspecialty includes the medical and surgical management of eye disorders found in children. Some of the more common disorders include amblyopia, strabismus, refractive error, cataract and glaucoma. These disorders may be related to neurological and endocrinological diseases, trauma, or aging changes in the extraocular muscles requiring medical, optical and surgical management. DR. Douglas R. Fredrick, MD NPI is 1053366633. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

395 HICKEY BLVD
DALY CITY, CA
ZIP 94015-770
Phone: (650) 742-2000

The NPI 1053366633 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 5/23/2006 and was last updated on 8/2/2022.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207WX0110XOphthalmologyPediatric Ophthalmology and Strabismus SpecialistA43821CALIFORNIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
100A438210MEDICAIDCALIFORNIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.