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General NPI Number Information
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NPI Number | 1295313211
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Entity Type | Organization
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Legal Business Name | BRADLEY J FRIEDMAN MD INC
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Dates
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Enumeration Date | 03/31/2021
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Last Update Date | 03/31/2021
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Provider Practice Location Address
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Address Line | 11613 W PICO BLVD
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City | LOS ANGELES
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State | CA
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Zip | 90064-2908
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Country | US
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Telephone | 310-268-2288
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Fax | 310-268-1553
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Provider Business Mailing Address
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Address Line | 2928 CORRAL CANYON RD
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City | MALIBU
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State | CA
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Zip | 90265-2915
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Country | US
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Telephone | 310-849-5773
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Fax |
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Authorized Official
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Title or Position | CEO/PRESIDENT
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Name | DR. BRADLEY J FRIEDMAN
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Credential | MD
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Telephone | 310-849-5773
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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