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NPI Code Detail

MEDICARE: GREGORY JAMES FRAZER AU.D. , PH.D.

MEDICARE:   GREGORY JAMES FRAZER  AU.D. , PH.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1174400000XSpecialistAU651CA
2231H00000XAudiologistAU651CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1023051588
Entity Type Code : Individual
Provider Name (Legal Business Name) : GREGORY JAMES FRAZER AU.D. , PH.D.
Provider Business Mailing Address
First Line : 11645 WILSHIRE BLVD
Second Line : SUITE# 600
City : LOS ANGELES
State : CA
Zip : 90025-1708
Country : US
Telephone Number : 310-477-5558
Fax Number : 310-477-7281
Provider Business Practice Location Address
First Line : 11645 WILSHIRE BLVD STE 601A
Second Line :
City : LOS ANGELES
State : CA
Zip : 90025-1708
Country : US
Telephone Number : 310-909-0180
Fax Number : 310-919-3181
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/13/2006
Last Update Date : 08/14/2020

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