MEDICARE: YAKOV FRIDMAN

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	183500000X	Pharmacist	76944	CA

General Provider Information

NPI Number	:	1538626387
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	YAKOV FRIDMAN

Provider Business Mailing Address
First Line	:	1147 6TH ST APT 205
Second Line	:
City	:	SANTA MONICA
State	:	CA
Zip	:	90403-5163
Country	:	US
Telephone Number	:	818-687-0424
Fax Number	:

Provider Business Practice Location Address
First Line	:	9045 WILSHIRE BLVD
Second Line	:
City	:	BEVERLY HILLS
State	:	CA
Zip	:	90211-1829
Country	:	US
Telephone Number	:	310-273-5252
Fax Number	:

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

Provider Enumeration Date	:	02/28/2019
Last Update Date	:	02/28/2019

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Directions to “ YAKOV FRIDMAN ” Practice Location

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