Healthcare Provider Details

I. General information

NPI: 1215808621
Provider Name (Legal Business Name): EVAN J FRIMMER
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/17/2025
Last Update Date: 09/28/2026
Certification Date: 09/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 CAMPUS RD
LOS ANGELES CA
90041-3314
US

IV. Provider business mailing address

250 E 73RD ST APT 16C
NEW YORK NY
10021-4312
US

V. Phone/Fax

Practice location:
  • Phone: 323-259-2500
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateDE
# 2
Primary TaxonomyY
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: