Provider Demographics
NPI:1669639092
Name:FRASER, DOUGLAS R (MD)
Entity type:Individual
Prefix:DR
First Name:DOUGLAS
Middle Name:R
Last Name:FRASER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 888102
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90088-8102
Mailing Address - Country:US
Mailing Address - Phone:916-441-0400
Mailing Address - Fax:916-441-0406
Practice Address - Street 1:2801 ATLANTIC AVE
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90806-1701
Practice Address - Country:US
Practice Address - Phone:562-933-1820
Practice Address - Fax:562-933-1819
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-22
Last Update Date:2025-01-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NV148232086S0127X, 2086S0102X, 2086S0127X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0102XAllopathic & Osteopathic PhysiciansSurgerySurgical Critical CareGroup - Multi-Specialty
No2086S0127XAllopathic & Osteopathic PhysiciansSurgeryTrauma Surgery