MEDICARE: DR. LAURANCE JASON FRIEDMAN M.D.

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	207P00000X	Emergency Medicine Physician	G80718	CA
2	207PE0004X	Emergency Medical Services (Emergency Medicine) Physician	G80718	CA

General Provider Information

NPI Number	:	1225022098
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LAURANCE JASON FRIEDMAN M.D.

Provider Business Mailing Address
First Line	:	PO BOX 51258
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90051-5558
Country	:	US
Telephone Number	:	310-423-8600
Fax Number	:	310-423-0424

Provider Business Practice Location Address
First Line	:	8700 BEVERLY BLVD.
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90048-1865
Country	:	US
Telephone Number	:	310-423-8600
Fax Number	:	310-423-0424

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/07/2005
Last Update Date	:	08/07/2014

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