Dominique M. Fradin-Read, M.D.,MPH

Primary specialty

SpecialistTaxonomy code 174400000X

License

A92155 Issued in CA

Practice address

12301 Wilshire Blvd
#315 Vitalife-MD
Los Angeles, CA 90025-1007

Phone

(424) 325-3368

Fax

(424) 288-5506

NPI assigned

Oct 6, 2006

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Dec 15, 2016 through Dec 15, 2026

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1160092800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1445644800000",
    "number": "1851488316",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5935 PLAYA VISTA DR",
            "address_2": "#415",
            "city": "PLAYA VISTA",
            "state": "CA",
            "postal_code": "900942130",
            "telephone_number": "818-406-1939",
            "fax_number": "310-745-1944"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12301 WILSHIRE BLVD",
            "address_2": "#315 VITALIFE-MD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900251007",
            "telephone_number": "424-325-3368",
            "fax_number": "424-288-5506"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRADIN-READ",
        "first_name": "DOMINIQUE",
        "middle_name": "M.",
        "credential": "M.D.,MPH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-06",
        "last_updated": "2015-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": "A92155",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Judith Mbewo Foyabo
• Arezoo Fozailoff, M.D.
• Anita Fozoonmehr
• FPTC Management Inc.
• Christian P Frable, MA, AMFT
• Lachanda Fradive
• Josue Fraga
• Linda Ann Fraga, MD
• Matthew Jordan Frager, M.D.
• Jose Fragoso

• Specialist in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Specialist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.