MR. GARY FEDOROFF

Counselor - Addiction (Substance Use Disorder)

Active Individual
NPI: 1093036717

Practice Address

171 CARLOS DR
San Rafael, CA 94903

Phone: (415) 755-2310

Specialties

Specialty Code Primary License
Counselor - Addiction (Substance Use Disorder) 101YA0400X Yes -

Frequently Asked Questions

NPI 1093036717 is the National Provider Identifier for MR. GARY FEDOROFF, a Counselor - Addiction (Substance Use Disorder) provider located in San Rafael, CA. This NPI was enumerated on June 16, 2010.
MR. GARY FEDOROFF practices at 171 CARLOS DR, San Rafael, CA 94903.

Quick Facts

NPI
1093036717
Type
Individual
Enumerated
Jun 16, 2010
Last Updated
Jun 16, 2010

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