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General NPI Number Information
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NPI Number | 1558635771
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Entity Type | Organization
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Legal Business Name | STEPHEN J FRIEDMAN, MD PC
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Dates
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Enumeration Date | 03/06/2012
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Last Update Date | 03/06/2012
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Provider Practice Location Address
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Address Line | 16255 VENTURA BLVD SUITE 120
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City | ENCINO
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State | CA
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Zip | 91436-2302
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Country | US
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Telephone | 818-986-3376
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Fax |
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Provider Business Mailing Address
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Address Line | 16255 VENTURA BLVD SUITE 120
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City | ENCINO
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State | CA
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Zip | 91436-2302
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Country | US
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Telephone | 818-986-3376
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. STEPHEN J FRIEDMAN
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Credential | M.D.
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Telephone | 818-986-3376
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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 | C41756
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License Number State | CA
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