Provider Demographics
NPI:1922286657
Name:FRATERS, MICHAEL (DO)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:
Last Name:FRATERS
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:376 VALLOMBROSA AVE
Mailing Address - Street 2:
Mailing Address - City:CHICO
Mailing Address - State:CA
Mailing Address - Zip Code:95926-3900
Mailing Address - Country:US
Mailing Address - Phone:530-891-1676
Mailing Address - Fax:530-891-1833
Practice Address - Street 1:376 VALLOMBROSA AVE
Practice Address - Street 2:
Practice Address - City:CHICO
Practice Address - State:CA
Practice Address - Zip Code:95926-3900
Practice Address - Country:US
Practice Address - Phone:530-891-1676
Practice Address - Fax:530-891-1833
Is Sole Proprietor?:No
Enumeration Date:2008-02-05
Last Update Date:2010-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A10091207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine