Individual provider Active NPI

Jonathan William Fraser, MD

  • Family Medicine Physician
  • Anaheim, CA
National Provider Identifier
1952861676
Registry record updated Jun 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A179077 Issued in CA
Practice address
5630 E Santa Ana Canyon Rd Ste 100
Anaheim, CA 92807-3122
Phone
(714) 257-6170
Fax
(714) 637-0212
NPI assigned
Mar 20, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X A179077 CA Primary

Addresses

Primary practice location

5630 E Santa Ana Canyon Rd Ste 100
Anaheim, CA 92807-3122

Mailing address

5630 E Santa Ana Canyon Rd Ste 100
Anaheim, CA 92807-3122
Phone (714) 257-6170

Other practice location 1

2075 San Joaquin Hills Rd
Newport Beach, CA 92660-6505
Phone (949) 760-9222

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250317002863 CA Practitioner - Family Practice 0749655314 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Jefferson Medical College of Thomas Jefferson University, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cornerhealth Medical Group IncGroup PAC ID 8820522006, 9 clinicians
Providence Medical FoundationGroup PAC ID 8921993205, 1,461 clinicians

Practice addresses (Care Compare)

2077 Harbor Blvd
Suite 100
Costa Mesa, CA 92627-9384
Phone (949) 740-7117

5630 E Santa Ana Canyon Rd
Anaheim, CA 92807-3122
Phone (714) 602-2400

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10
Removal of skin lesions1-10
Removal or shaving of skin growth1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A179077CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Medical Foundation Current Accepting new patients
Providence Medical Foundation CurrentSince Jun 23, 2025 Accepting new patients
Providence Medical Foundation Family Medicine CurrentSince Jun 23, 2025 Accepting new patients
Marque Medical Clinic, Inc. Family Medicine CurrentSince Feb 6, 2025 Accepting new patients
Marque Medical Clinic, Inc CurrentSince Feb 6, 2025 Accepting new patients
Cornerhealth Medical Group Inc CurrentSince Jan 9, 2025 Accepting new patients
Regents of the University of California Family Medicine Past Accepting new patients
Providence Medical Foundation Family Medicine Past Accepting new patients

Locations

5630 E Santa Ana Canyon Rd
Ste 100
Anaheim, CA 92807
Phone (714) 257-6170

5630 E Santa Ana Canyon Rd
Anaheim, CA 92807
Phone (714) 257-6170

19333 Bear Valley Rd
Ste 106
Apple Valley, CA 92308
Phone (760) 240-5505

2077 Harbor Blvd
Ste 100
Costa Mesa, CA 92627
Phone (949) 740-7117

2077 Harbor Blvd
Ste A
Costa Mesa, CA 92627
Phone (949) 414-2934

1950 Sunny Crest Dr
Ste 2900
Fullerton, CA 92835

100 E Valencia Mesa Dr
Ste 105
Fullerton, CA 92835
Phone (714) 446-5200

21770 LK FRST Dr
Ste 109
Lake Forest, CA 92630
Phone (877) 693-6266

2075 San Joaquin Hills Rd
Newport Beach, CA 92660
Phone (877) 693-6266

2501 E Chapman Ave
Ste 101
Orange, CA 92869
Phone (714) 628-3300

4490 Fanuel St
Ste 100
San Diego, CA 92109

1165 Montgomery Dr
#1112
Santa Rosa, CA 95405
Phone (707) 546-3210

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1553040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750896000000",
    "number": "1952861676",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5630 E SANTA ANA CANYON RD STE 100",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928073122",
            "telephone_number": "714-257-6170",
            "fax_number": "714-637-0212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5630 E SANTA ANA CANYON RD STE 100",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928073122",
            "telephone_number": "714-257-6170",
            "fax_number": "714-637-0212"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2075 San Joaquin Hills Rd",
            "address_purpose": "LOCATION",
            "city": "Newport Beach",
            "state": "CA",
            "postal_code": "926606505",
            "country_code": "US",
            "telephone_number": "949-760-9222",
            "fax_number": "949-644-4312",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FRASER",
        "first_name": "JONATHAN",
        "middle_name": "WILLIAM",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-03-20",
        "last_updated": "2025-06-26",
        "certification_date": "2025-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A179077",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Anaheim, CA

Sources for this page

Verify at the official NPI Registry.