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General NPI Number Information
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NPI Number | 1003240243
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Entity Type | Individual
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Provider Name | FREEDMAN OUK
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Gender | Male
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Dates
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Enumeration Date | 08/23/2013
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Last Update Date | 08/23/2013
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Provider Practice Location Address
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Address Line | 2400 MOORPARK AVE STE 300
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City | SAN JOSE
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State | CA
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Zip | 95128-2680
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Country | US
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Telephone | 408-275-2730
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Fax |
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Provider Business Mailing Address
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Address Line | 2482 S KING RD APT 456
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City | SAN JOSE
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State | CA
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Zip | 95122-1816
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Country | US
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Telephone | 408-975-2730
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 172V00000X
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Taxonomy Name | Community Health Worker
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License Number |
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License Number State |
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