Doctor Name: | DR. EZRA THEODORE FRASER |
NPI Number: | 1023240561 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D. |
License Number: | HOSPITAL LICENSE |
Business Practice Address: | 421 30th St Hermosa Beach, CA - 902542131 |
Business Phone Number: | 4159025621 |
Business Fax Number: | |
Mailing Address: | 421 30th St, HERMOSA BEACH |
State: | CA |
Postal Code: | 902542131 |
Phone Number: | 4159025621 |
Fax Number: | |
NPI Enumeration Date: | 08/18/2009 |
NPI Last Update Date: | 05/24/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 2085R0202X |
License Number: | HOSPITAL LICENSE |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | CT |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | Radiology |
Taxonomy Specialization: | Diagnostic Radiology |
Taxonomy Definition: | A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |