Provider Demographics
NPI:1104809243
Name:MINOR, FRANK WEBER (MD)
Entity type:Individual
Prefix:DR
First Name:FRANK
Middle Name:WEBER
Last Name:MINOR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:152 CATHERINE LN
Mailing Address - Street 2:STE A
Mailing Address - City:GRASS VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:95945-5756
Mailing Address - Country:US
Mailing Address - Phone:530-273-1111
Mailing Address - Fax:530-273-1573
Practice Address - Street 1:152 CATHERINE LN
Practice Address - Street 2:STE A
Practice Address - City:GRASS VALLEY
Practice Address - State:CA
Practice Address - Zip Code:95945-5756
Practice Address - Country:US
Practice Address - Phone:530-273-1111
Practice Address - Fax:530-273-1573
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-22
Last Update Date:2010-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC420170174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00C420170OtherORIGINAL MEDICARE PROVIDER NUMBER
CAA37729Medicare UPIN