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:
Health care specialties
| Specialty | Code | License # | 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 16 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1366405953 | NPPES |
| California | MEDICAID | 00C301820 |
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