Provider Demographics
NPI:1548440258
Name:FREDERICK SCHLAFF, MD, INC.
Entity type:Organization
Organization Name:FREDERICK SCHLAFF, MD, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:FREDERICK
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHLAFF
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:530-894-2570
Mailing Address - Street 1:1660 HUMBOLDT RD STE 3
Mailing Address - Street 2:
Mailing Address - City:CHICO
Mailing Address - State:CA
Mailing Address - Zip Code:95928-9199
Mailing Address - Country:US
Mailing Address - Phone:530-894-2570
Mailing Address - Fax:530-894-4030
Practice Address - Street 1:1660 HUMBOLDT RD STE 3
Practice Address - Street 2:
Practice Address - City:CHICO
Practice Address - State:CA
Practice Address - Zip Code:95928-9199
Practice Address - Country:US
Practice Address - Phone:530-894-2570
Practice Address - Fax:530-894-4030
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-09
Last Update Date:2007-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA22601103TP0016X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TP0016XBehavioral Health & Social Service ProvidersPsychologistPrescribing (Medical)Group - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA82654Medicare UPIN