MEDICARE: DR. JOHN K. FRAZIER 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
1	207X00000X	Orthopaedic Surgery Physician	G33380	CA
2	207XX0005X	Sports Medicine (Orthopaedic Surgery) Physician	G33380	CA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	20000538	OTHER	CA	RAIL ROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	00G333801	OTHER	CA	BLUE SHIELD
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1972570752
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOHN K. FRAZIER MD

Provider Business Mailing Address
First Line	:	200 PORTER DR
Second Line	:	SUITE 101
City	:	SAN RAMON
State	:	CA
Zip	:	94583-1587
Country	:	US
Telephone Number	:	925-838-1440
Fax Number	:

Provider Business Practice Location Address
First Line	:	5801 NORRIS CANYON RD
Second Line	:	SUITE 210
City	:	SAN RAMON
State	:	CA
Zip	:	94583-5440
Country	:	US
Telephone Number	:	925-355-7350
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/01/2006
Last Update Date	:	04/26/2010

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Directions to “ DR. JOHN K. FRAZIER MD” Practice Location

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