Provider Demographics
NPI:1598825309
Name:FRAIMAN, GENISE NICOLE (MD)
Entity Type:Individual
Prefix:
First Name:GENISE
Middle Name:NICOLE
Last Name:FRAIMAN
Suffix:
Gender:F
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:PO BOX 373
Mailing Address - Street 2:
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90213-0373
Mailing Address - Country:US
Mailing Address - Phone:310-413-5458
Mailing Address - Fax:
Practice Address - Street 1:9001 WILSHIRE BLVD STE 200
Practice Address - Street 2:
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90211-1840
Practice Address - Country:US
Practice Address - Phone:310-413-5458
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-11
Last Update Date:2010-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA79921207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA79921Medicare ID - Type UnspecifiedPROVIDER