Healthcare Provider Details
I. General information
NPI: 1578576013
Provider Name (Legal Business Name): MICHAEL L. FRIEDMAN, MD., A PROFESSIONAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/15/2006
Last Update Date: 12/14/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4201 TORRANCE BLVD STE 660
TORRANCE CA
90503-4522
US
IV. Provider business mailing address
4201 TORRANCE BLVD STE 660
TORRANCE CA
90503-4522
US
V. Phone/Fax
- Phone: 310-316-4373
- Fax: 310-316-1291
- Phone: 310-316-4373
- Fax: 310-316-1291
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QP2300X |
| Taxonomy | Primary Care Clinic/Center |
| License Number | G15327 |
| License Number State | CA |
VIII. Authorized Official
Name: DR.
MICHAEL
L.
FRIEDMAN
Title or Position: PRESIDENT
Credential: M.D.
Phone: 310-316-4373