MEDICARE: DR. RONALD JAY 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	174400000X	Specialist	G17191	CA

General Provider Information

NPI Number	:	1811069982
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RONALD JAY FRIEDMAN M.D.

Provider Business Mailing Address
First Line	:	20750 VENTURA BLVD
Second Line	:	SUITE 106
City	:	WOODLAND HILLS
State	:	CA
Zip	:	91364-2338
Country	:	US
Telephone Number	:	818-346-3500
Fax Number	:	818-251-1112

Provider Business Practice Location Address
First Line	:	5706 CORSA AVE
Second Line	:	SUITE 200-O
City	:	WESTLAKE VILLAGE
State	:	CA
Zip	:	91362-4057
Country	:	US
Telephone Number	:	800-400-4674
Fax Number	:	818-251-1112

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

Provider Enumeration Date	:	11/14/2006
Last Update Date	:	07/09/2007

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