Healthcare Provider Details

I. General information

NPI: 1740280445
Provider Name (Legal Business Name): BEHAVIORAL HEALTH MEDICAL GROUP OF BEVERLY HILLS INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/26/2005
Last Update Date: 08/05/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9171 WILSHIRE BOULEVARD SUITE 310
BEVERLY HILLS CA
90210-5516
US

IV. Provider business mailing address

9171 WILSHIRE BOULEVARD SUITE 310
BEVERLY HILLS CA
90210-5516
US

V. Phone/Fax

Practice location:
  • Phone: 310-274-4372
  • Fax: 310-274-5146
Mailing address:
  • Phone: 310-274-4372
  • Fax: 310-274-5146

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberFNP24674
License Number StateCA

VIII. Authorized Official

Name: BARRY D. FRIEDMAN
Title or Position: MEDICAL DIRECTOR / PSYCHIATRIST
Credential: M.D.
Phone: 310-274-4372