Healthcare Provider Details

I. General information

NPI: 1447475447
Provider Name (Legal Business Name): RICHARD FRIEDMAN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/16/2007
Last Update Date: 02/29/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

315 9TH ST
SANTA MONICA CA
90402-1925
US

IV. Provider business mailing address

315 9TH ST
SANTA MONICA CA
90402-1925
US

V. Phone/Fax

Practice location:
  • Phone: 310-393-8045
  • Fax:
Mailing address:
  • Phone: 310-393-8045
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0015X
TaxonomyPsychosomatic Medicine Physician
License NumberG8817
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: