Provider Demographics
NPI:1497806822
Name:FRAZEE, DONALD MICHAEL (DC)
Entity Type:Individual
Prefix:
First Name:DONALD
Middle Name:MICHAEL
Last Name:FRAZEE
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17995 US HIGHWAY 18
Mailing Address - Street 2:STE 3
Mailing Address - City:APPLE VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92307-2190
Mailing Address - Country:US
Mailing Address - Phone:760-961-2225
Mailing Address - Fax:760-961-2233
Practice Address - Street 1:17995 HIGHWAY 18, SUITE 3
Practice Address - Street 2:
Practice Address - City:APPLE VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92307
Practice Address - Country:US
Practice Address - Phone:760-961-2225
Practice Address - Fax:760-961-2233
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-13
Last Update Date:2020-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA21973111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAU36713Medicare UPIN
CADC0219730Medicare ID - Type Unspecified