Healthcare Provider Details

I. General information

NPI: 1033206891
Provider Name (Legal Business Name): JULIE FREEDMAN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/05/2006
Last Update Date: 05/09/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2450 ASHBY AVE ROOM 5505
BERKELEY CA
94705-2067
US

IV. Provider business mailing address

3687 MT DIABLO BLVD SUITE 200
LAFAYETTE CA
94549-3717
US

V. Phone/Fax

Practice location:
  • Phone: 510-204-4444
  • Fax: 510-649-8287
Mailing address:
  • Phone: 916-854-6975
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberA86989
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberA86989
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: