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Individual

KEITH EDWARD FRAKER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
751 S BASCOM AVE, DIAGNOSTIC IMAGING DEPARTMENT, SAN JOSE, CA 95128-2604
(408) 885-6370
Mailing address
751 S BASCOM AVE, SAN JOSE, CA 95128-2604
(408) 885-5000

Taxonomy

Speciality
Code
Description
License number
State
2085B0100X
Body Imaging Physician
C30182
CA
2085R0202X
Diagnostic Radiology Physician
Primary
C30182
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00C301820
CA
Enumeration date
04/06/2006
Last updated
01/07/2009
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