Individual
MR. ANDRE L FRAZIER SR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3625 14TH ST, RIVERSIDE, CA 92501-3815
(951) 358-6919
Mailing address
26082 PRADO ST, MORENO VALLEY, CA 92555-2807
(951) 552-4844
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
08/03/2017
Last updated
08/03/2017
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