Healthcare Provider Details

I. General information

NPI: 1124341086
Provider Name (Legal Business Name): STANLEY KEITH FRENCHER JR. M.D. M.P.H.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/08/2010
Last Update Date: 01/04/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1670 E 120TH ST MODULE 3A, UROLOGY
LOS ANGELES CA
90059-3026
US

IV. Provider business mailing address

924 WESTWOOD BLVD SUITE 1000
LOS ANGELES CA
90024-2910
US

V. Phone/Fax

Practice location:
  • Phone: 424-338-1559
  • Fax: 310-223-0977
Mailing address:
  • Phone: 310-794-8492
  • Fax: 310-794-2538

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License NumberA 109025
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberA 109025
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code208800000X
TaxonomyUrology Physician
License NumberA109025
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: