Healthcare Provider Details

I. General information

NPI: 1326399247
Provider Name (Legal Business Name): RONALD K. FREUND M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/02/2012
Last Update Date: 02/06/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1507 7TH ST #260
SANTA MONICA CA
90401-2605
US

IV. Provider business mailing address

1507 7TH ST #260
SANTA MONICA CA
90401-2605
US

V. Phone/Fax

Practice location:
  • Phone: 310-963-2927
  • Fax: 310-963-2927
Mailing address:
  • Phone: 310-963-2927
  • Fax: 310-963-2927

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207XS0106X
TaxonomyOrthopaedic Hand Surgery Physician
License NumberG52526
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: