MEDICARE: DR. ROBERT FREUNDLICH M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist	G048563	CA

General Provider Information

NPI Number	:	1881692093
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROBERT FREUNDLICH M.D.

Provider Business Mailing Address
First Line	:	16311 VENTURA BLVD
Second Line	:	SUITE 680
City	:	ENCINO
State	:	CA
Zip	:	91436-2124
Country	:	US
Telephone Number	:	818-990-8561
Fax Number	:	818-990-4432

Provider Business Practice Location Address
First Line	:	16311 VENTURA BLVD
Second Line	:	SUITE 680
City	:	ENCINO
State	:	CA
Zip	:	91436-2124
Country	:	US
Telephone Number	:	818-990-8561
Fax Number	:	818-990-4432

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/12/2005
Last Update Date	:	12/09/2008

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