Healthcare Provider Details

I. General information

NPI: 1235168501
Provider Name (Legal Business Name): BEN FRIEDMAN, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/30/2006
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10771 SHERMAN WAY
SUN VALLEY CA
91352-5155
US

IV. Provider business mailing address

10771 SHERMAN WAY
SUN VALLEY CA
91352-5155
US

V. Phone/Fax

Practice location:
  • Phone: 818-503-8806
  • Fax: 818-503-8826
Mailing address:
  • Phone: 818-503-8806
  • Fax: 818-503-8826

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberPHY44839
License Number StateCA

VIII. Authorized Official

Name: MR. BEN FRIEDMAN
Title or Position: OWNER
Credential: R.PH
Phone: 818-262-6222