Provider Demographics
NPI:1285772152
Name:NOODLEMAN, FRANK RICHARD (MD)
Entity type:Individual
Prefix:DR
First Name:FRANK
Middle Name:RICHARD
Last Name:NOODLEMAN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:525 SOUTH DR STE 115
Mailing Address - Street 2:
Mailing Address - City:MOUNTAIN VIEW
Mailing Address - State:CA
Mailing Address - Zip Code:94040-4211
Mailing Address - Country:US
Mailing Address - Phone:650-969-5600
Mailing Address - Fax:650-969-0360
Practice Address - Street 1:18988 COX AVE
Practice Address - Street 2:
Practice Address - City:SARATOGA
Practice Address - State:CA
Practice Address - Zip Code:95070-4154
Practice Address - Country:US
Practice Address - Phone:408-253-4407
Practice Address - Fax:408-253-4499
Is Sole Proprietor?:No
Enumeration Date:2007-02-02
Last Update Date:2024-08-30
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAG42229207N00000X, 207ND0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ND0101XAllopathic & Osteopathic PhysiciansDermatologyMOHS-Micrographic Surgery
No207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA48868Medicare UPIN