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NPI Code Detail

MEDICARE: BRADLEY WALTERS FRAZEE MD

MEDICARE: BRADLEY WALTERS FRAZEE MD
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
1207P00000XEmergency Medicine PhysicianG73123CA

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 : 1447241765
Entity Type Code : Individual
Provider Name (Legal Business Name) : BRADLEY WALTERS FRAZEE MD
Provider Business Mailing Address
First Line : 4301 NORTHSTAR WAY
Second Line :
City : MODESTO
State : CA
Zip : 95356-9262
Country : US
Telephone Number : 209-342-2300
Fax Number : 209-524-4240
Provider Business Practice Location Address
First Line : 1411 E 31ST ST
Second Line :
City : OAKLAND
State : CA
Zip : 94602-1018
Country : US
Telephone Number : 209-342-2300
Fax Number : 209-524-4240
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/04/2005
Last Update Date : 07/08/2007

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Directions to “ BRADLEY WALTERS FRAZEE MD” Practice Location

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