Basic Information
| Provider Information | |||||||||
| NPI: | 1053809129 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | FREYJA MEDICAL CLINIC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 570 PRICE AVE STE 100 | ||||||||
| Address2: | |||||||||
| City: | REDWOOD CITY | ||||||||
| State: | CA | ||||||||
| PostalCode: | 940631433 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6507011882 | ||||||||
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| Practice Location | |||||||||
| Address1: | 570 PRICE AVE STE 100 | ||||||||
| Address2: | |||||||||
| City: | REDWOOD CITY | ||||||||
| State: | CA | ||||||||
| PostalCode: | 940631433 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6507011882 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/24/2018 | ||||||||
| LastUpdateDate: | 04/24/2018 | ||||||||
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| AuthorizedOfficialLastName: | RYDFORS | ||||||||
| AuthorizedOfficialFirstName: | JAN | ||||||||
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| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 6507011882 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207V00000X | CA | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology |
No ID Information.