Organization
LARI L FRAZEE DO PC
Active
Other names
Ponderosa Pediatrics
Organization subpart
No
Provider details
NPI number
Authorized official
LARI FRAZEE DO (OWNER)
(775) 391-5998
Entity
Organization
Contact information
Practice address
6512 S MCCARRAN BLVD STE D, RENO, NV 89509-6141
(775) 391-5998
Mailing address
6512 S MCCARRAN BLVD STE D, RENO, NV 89509-6141
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PENDING
ANTHEM BCBS
—
Enumeration date
06/13/2019
Last updated
02/27/2025
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