Healthcare Provider Details

I. General information

NPI: 1770450181
Provider Name (Legal Business Name): ALEX FRIDMAN, M.D., A PROFESSIONAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/21/2025
Last Update Date: 08/12/2026
Certification Date: 08/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

747 E ALTADENA DR
ALTADENA CA
91001-2302
US

IV. Provider business mailing address

747 E ALTADENA DR
ALTADENA CA
91001-2302
US

V. Phone/Fax

Practice location:
  • Phone: 818-570-2640
  • Fax: 425-305-4713
Mailing address:
  • Phone: 818-570-2640
  • Fax: 425-305-4713

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: ALEX FRIDMAN JR.
Title or Position: PHYSICIAN
Credential: MD
Phone: 213-864-4615