MEDICARE: B.JOHN FREEMAN,M.D.,INC.:

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207LP2900X	Pain Medicine (Anesthesiology) Physician	G46887	CA

General Provider Information

NPI Number	:	1093057929
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	B.JOHN FREEMAN,M.D.,INC.:

Provider Business Mailing Address
First Line	:	2525 N CATALINA ST
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90027-1132
Country	:	US
Telephone Number	:	323-663-4595
Fax Number	:	323-663-0120

Provider Business Practice Location Address
First Line	:	2525 N CATALINA ST
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90027-1132
Country	:	US
Telephone Number	:	323-663-4595
Fax Number	:	323-663-0120

Authorized Official
Title or Position	:	OWNER/PRESIDENT
Name	:	JOHN BARRY FREEMAN
Credential	:	MD
Telephone Number	:	818-288-8380

Provider Enumeration Date	:	03/18/2013
Last Update Date	:	03/18/2013

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