Healthcare Provider Details

I. General information

NPI: 1336338458
Provider Name (Legal Business Name): MICHAEL LANGE FRIEDMAN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/15/2007
Last Update Date: 10/15/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4201 TORRANCE BLVD SUITE 660
TORRANCE CA
90503-4504
US

IV. Provider business mailing address

4201 TORRANCE BLVD SUITE 660
TORRANCE CA
90503-4504
US

V. Phone/Fax

Practice location:
  • Phone: 310-316-4373
  • Fax: 310-316-1291
Mailing address:
  • Phone: 310-316-4373
  • Fax: 310-316-1291

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License NumberG15327
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: