Provider Demographics
NPI:1902808413
Name:MCKNIGHT, FRANK GALEN (MD)
Entity Type:Individual
Prefix:DR
First Name:FRANK
Middle Name:GALEN
Last Name:MCKNIGHT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:2340 WARD ST
Mailing Address - Street 2:STE.204
Mailing Address - City:BERKELEY
Mailing Address - State:CA
Mailing Address - Zip Code:94705-1124
Mailing Address - Country:US
Mailing Address - Phone:510-658-2931
Mailing Address - Fax:510-658-2931
Practice Address - Street 1:2340 WARD ST
Practice Address - Street 2:STE.204
Practice Address - City:BERKELEY
Practice Address - State:CA
Practice Address - Zip Code:94705-1124
Practice Address - Country:US
Practice Address - Phone:510-658-2931
Practice Address - Fax:510-658-2931
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-15
Last Update Date:2011-10-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAC271062084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
P00147514Medicare ID - Type UnspecifiedPALMETTO RAILROAD MEDICAR
CAF26861Medicare UPIN
CAZZZ2632ZMedicare ID - Type UnspecifiedMEDICARE NHIC