Provider Demographics
NPI:1124254388
Name:FRYE, DOUGLAS M (MD, MPH)
Entity type:Individual
Prefix:DR
First Name:DOUGLAS
Middle Name:M
Last Name:FRYE
Suffix:
Gender:M
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 S COMMONWEALTH AVE STE 1920
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90005-4036
Mailing Address - Country:US
Mailing Address - Phone:213-351-8196
Mailing Address - Fax:
Practice Address - Street 1:600 S COMMONWEALTH AVE STE 1920
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90005-4036
Practice Address - Country:US
Practice Address - Phone:213-351-8196
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-06-02
Last Update Date:2009-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG567262083P0901X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083P0901XAllopathic & Osteopathic PhysiciansPreventive MedicinePublic Health & General Preventive Medicine