Provider Demographics
NPI:1891737060
Name:HOWARD, FRANK DAVIS IV (MD)
Entity Type:Individual
Prefix:
First Name:FRANK
Middle Name:DAVIS
Last Name:HOWARD
Suffix:IV
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1502 ARROW HWY
Mailing Address - Street 2:
Mailing Address - City:LA VERNE
Mailing Address - State:CA
Mailing Address - Zip Code:91750-5318
Mailing Address - Country:US
Mailing Address - Phone:909-593-4333
Mailing Address - Fax:909-593-5588
Practice Address - Street 1:1280 CORONA POINTE CT
Practice Address - Street 2:SUITE 112
Practice Address - City:CORONA
Practice Address - State:CA
Practice Address - Zip Code:92879-1770
Practice Address - Country:US
Practice Address - Phone:951-898-2828
Practice Address - Fax:951-898-2811
Is Sole Proprietor?:No
Enumeration Date:2006-06-12
Last Update Date:2010-08-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAG81970174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAE42315Medicare UPIN