Healthcare Provider Details

I. General information

NPI: 1316038052
Provider Name (Legal Business Name): ARTHUR FRIEDMAN OD APOC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/27/2006
Last Update Date: 06/17/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7890 HAVEN AVE. #17
RANCHO CUCAMONGA CA
91730
US

IV. Provider business mailing address

7890 HAVEN AVE. #17
RANCHO CUCAMONGA CA
91730
US

V. Phone/Fax

Practice location:
  • Phone: 909-987-3330
  • Fax:
Mailing address:
  • Phone: 909-987-3330
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number6922T
License Number StateCA

VIII. Authorized Official

Name: DR. ARTHUR FRIEDMAN
Title or Position: OWNER
Credential: O.D.
Phone: 909-987-3330