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General NPI Number Information
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NPI Number | 1881870285
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Entity Type | Individual
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Provider Name | JASON TODD FRIEDMAN C.P.O.
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Gender | Male
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Dates
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Enumeration Date | 01/15/2008
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Last Update Date | 06/24/2010
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Provider Practice Location Address
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Address Line | 15644 POMERADO RD SUITE 103
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City | POWAY
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State | CA
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Zip | 92064-2400
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Country | US
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Telephone | 858-613-0958
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Fax | 858-613-0959
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Provider Business Mailing Address
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Address Line | 15644 POMERADO RD SUITE 103
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City | POWAY
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State | CA
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Zip | 92064-2400
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Country | US
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Telephone | 858-613-0958
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Fax | 858-613-0959
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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 | 335E00000X
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Taxonomy Name | Prosthetic/Orthotic Supplier
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License Number | CPO1661
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License Number State | CA
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