Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Justin Fredericks, DO

Individual provider General Practice Physician · NPI 1487356176

Justin Fredericks, DO is a General Practice Physician in San Diego, California. Licensed in Indiana. Registered with an NPI since 2023.

Licensed in
IN
In the registry since
2023
What do these letters mean?
DO — Doctor of Osteopathic Medicine
A fully licensed physician, trained like an MD with additional musculoskeletal training. Equivalent practice rights in all 50 states.

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Practice location Address checks out

2841 Rendova Rd
San Diego, CA 92155-5779
Phone: (727) 742-6825
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

General Practice Physician (primary) Taxonomy 208D00000X · Licence 02007896A (IN)

Record details

NPI number1487356176
Entity typeIndividual (Type 1)
GenderMale
Credentials DO
Sole proprietorNo
NPI enumeratedMarch 20, 2023
Last updated in NPPESNovember 25, 2024
Certification dateNovember 25, 2024

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