Healthcare Provider Details

I. General information

NPI: 1588303440
Provider Name (Legal Business Name): CONNIE FRIEDMAN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/31/2022
Last Update Date: 10/15/2025
Certification Date: 10/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 HILLMONT AVE BLDG 340
VENTURA CA
93003-1651
US

IV. Provider business mailing address

300 HILLMONT AVE BLDG 340
VENTURA CA
93003-1651
US

V. Phone/Fax

Practice location:
  • Phone: 805-652-6228
  • Fax:
Mailing address:
  • Phone: 805-652-6228
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberA190780
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: