Healthcare Provider Details

I. General information

NPI: 1982708558
Provider Name (Legal Business Name): RICK ADAM FRIEDMAN MD, PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/12/2006
Last Update Date: 08/30/2024
Certification Date: 08/27/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9444 MEDICAL CENTER DR ROOM 3-016
LA JOLLA CA
92093-2777
US

IV. Provider business mailing address

9444 MEDICAL CENTER DR RM 3-016
LA JOLLA CA
92037-1337
US

V. Phone/Fax

Practice location:
  • Phone: 858-657-5280
  • Fax:
Mailing address:
  • Phone: 858-657-5280
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License NumberG67571
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code207YX0901X
TaxonomyOtology & Neurotology Physician
License NumberG67571
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: