| Doctor Name: | GAIL JUNE FREDERICKS |
| NPI Number: | 1659468999 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MD |
| License Number: | A61646 |
| Business Practice Address: | 121 Diana St Placerville, CA - 956673313 |
| Business Phone Number: | 5305592880 |
| Business Fax Number: | 5306222979 |
| Mailing Address: | 121 Diana St, PLACERVILLE |
| State: | CA |
| Postal Code: | 956673313 |
| Phone Number: | 5305592880 |
| Fax Number: | 5306222979 |
| NPI Enumeration Date: | 10/06/2006 |
| NPI Last Update Date: | 07/28/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | A61646 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |