Active NPI
Conrad J. Frey, M.D.
- Family Medicine Physician
- San Diego, CA
National Provider Identifier
1164564142
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- A43087
- Practice address
- 4550 Saratoga Ave
San Diego, CA 92107-2340 - Phone
- (619) 517-8171
- NPI assigned
- Feb 13, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | A43087 | CA | Primary |
Addresses
Primary practice location
4550 Saratoga Ave
San Diego, CA 92107-2340
Mailing address
4550 Saratoga Ave
San Diego, CA 92107-2340
Phone (619) 517-8171
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00A430870 | Medicaid | CA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| San Diego Center for Family Health | Family Medicine | Past | Accepting new patients |
| Martin C Fineman MD Med Corp | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Internal Medicine Physician
- San Diego, CA
- NPI 1689979114
-
- Internal Medicine Physician
- San Diego, CA
- NPI 1306959721
Family Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1171324800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1164564142",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4550 SARATOGA AVE",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921072340",
"telephone_number": "619-517-8171"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4550 SARATOGA AVE",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921072340",
"telephone_number": "619-517-8171"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FREY",
"first_name": "CONRAD",
"middle_name": "J.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-02-13",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "CA",
"license": "A43087",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00A430870",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in San Diego, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.