Provider Demographics
NPI:1952861676
Name:FRASER, JONATHAN WILLIAM (MD)
Entity type:Individual
Prefix:DR
First Name:JONATHAN
Middle Name:WILLIAM
Last Name:FRASER
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:5630 E SANTA ANA CANYON RD STE 100
Mailing Address - Street 2:
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92807-3122
Mailing Address - Country:US
Mailing Address - Phone:714-257-6170
Mailing Address - Fax:714-637-0212
Practice Address - Street 1:5630 E SANTA ANA CANYON RD STE 100
Practice Address - Street 2:
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92807-3122
Practice Address - Country:US
Practice Address - Phone:714-257-6170
Practice Address - Fax:714-637-0212
Is Sole Proprietor?:No
Enumeration Date:2019-03-20
Last Update Date:2025-06-26
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAA179077207Q00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine