Provider Demographics
NPI:1598760589
Name:MAYER, FRANK EDWARD (MD)
Entity Type:Individual
Prefix:
First Name:FRANK
Middle Name:EDWARD
Last Name:MAYER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9850 GENESEE AVE
Mailing Address - Street 2:STE 930
Mailing Address - City:LA JOLLA
Mailing Address - State:CA
Mailing Address - Zip Code:92037-1229
Mailing Address - Country:US
Mailing Address - Phone:858-457-3737
Mailing Address - Fax:858-550-9047
Practice Address - Street 1:9850 GENESEE AVE
Practice Address - Street 2:STE 930
Practice Address - City:LA JOLLA
Practice Address - State:CA
Practice Address - Zip Code:92037-1229
Practice Address - Country:US
Practice Address - Phone:858-457-3737
Practice Address - Fax:858-550-9047
Is Sole Proprietor?:No
Enumeration Date:2005-06-16
Last Update Date:2009-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG40234207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G402340Medicaid
CAG40234Medicare ID - Type Unspecified
CAA48150Medicare UPIN