Fraser, Ezra Theodore

Fraser, Ezra Theodore is an sole proprietor health care provider with primary practice located at 421 30Th St , Hermosa Beach CA 90254-2131. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Diagnostic Radiology, Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology. Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology is his primary health care specialty. Fraser, Ezra Theodore can be contacted via phone (415) 902-5621.

Contact Information

Primary practice address
421 30Th St Hermosa Beach CA 90254-2131
Phone: (415) 902-5621
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X HOSPITAL LICENSE Connecticut
Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology 2085R0204X A112170 California

Profile Details

NPI number 1023240561
LBN Legal business name Fraser, Ezra Theodore
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 18th, 2009
Last updated May 24th, 2011 - about 13 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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