Healthcare Provider Details

I. General information

NPI: 1306754916
Provider Name (Legal Business Name): ELI FRIEDMAN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/01/2026
Last Update Date: 09/18/2026
Certification Date: 09/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

399 DRAKE AVE
MONTEREY CA
93940-7504
US

IV. Provider business mailing address

1668 LUXTON ST
SEASIDE CA
93955-3847
US

V. Phone/Fax

Practice location:
  • Phone: 831-643-9069
  • Fax:
Mailing address:
  • Phone: 415-419-7727
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: