Provider Demographics
NPI:1528098860
Name:MORGAN, FREDRIC CHARLES (MD)
Entity type:Individual
Prefix:DR
First Name:FREDRIC
Middle Name:CHARLES
Last Name:MORGAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:5776 STONERIDGE MALL RD
Mailing Address - Street 2:SUITE 175
Mailing Address - City:PLEASANTON
Mailing Address - State:CA
Mailing Address - Zip Code:94588-2832
Mailing Address - Country:US
Mailing Address - Phone:925-600-0660
Mailing Address - Fax:925-600-0987
Practice Address - Street 1:5776 STONERIDGE MALL RD
Practice Address - Street 2:SUITE 175
Practice Address - City:PLEASANTON
Practice Address - State:CA
Practice Address - Zip Code:94588-2832
Practice Address - Country:US
Practice Address - Phone:925-600-0660
Practice Address - Fax:925-600-0987
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-03
Last Update Date:2014-08-25
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAG60914208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G609140Medicaid
CA00G609140Medicaid
CA00G609141Medicare PIN