Healthcare Provider Details

I. General information

NPI: 1598089286
Provider Name (Legal Business Name): JOSHUA FREEDMAN MD, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/24/2010
Last Update Date: 03/24/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

921 WESTWOOD BLVD STE 220
LOS ANGELES CA
90024
US

IV. Provider business mailing address

921 WESTWOOD BLVD STE 220
LOS ANGELES CA
90024
US

V. Phone/Fax

Practice location:
  • Phone: 310-208-1744
  • Fax: 310-824-1883
Mailing address:
  • Phone: 310-208-1744
  • Fax: 310-824-1883

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberG66478
License Number StateCA

VIII. Authorized Official

Name: JOSHUA FREEDMAN
Title or Position: PRESIDENT
Credential: M.D.
Phone: 310-208-1744