Fraker, Keith Edward

Fraker, Keith Edward is an individual health care provider with primary practice located at 751 S Bascom Ave Diagnostic Imaging Department, San Jose CA 95128-2604. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Body Imaging, Allopathic & Osteopathic Physicians / Diagnostic Radiology. Allopathic & Osteopathic Physicians / Diagnostic Radiology is his primary health care specialty. Fraker, Keith Edward can be contacted via phone (408) 885-6370.

Contact Information

Primary practice address
751 S Bascom Ave Diagnostic Imaging Department San Jose CA 95128-2604
Phone: (408) 885-6370
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Body Imaging 2085B0100X C30182 California
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X C30182 California

Profile Details

NPI number 1366405953
LBN Legal business name Fraker, Keith Edward
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 6th, 2006
Last updated Jan 7th, 2009 - about 15 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1366405953 NPPES
California MEDICAID 00C301820

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