Individual
RANDY A FRALICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
600 COFFEE RD, MODESTO, CA 95355-4201
(209) 524-1211
Mailing address
600 COFFEE RD, MODESTO, CA 95355-4201
(209) 524-1211
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
G87066
CA
2085U0001X
Diagnostic Ultrasound Physician
G87066
CA
208800000X
Urology Physician
Primary
G87066
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G870660
—
CA
Enumeration date
05/05/2006
Last updated
01/04/2022
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