MEDICARE: FRIDA JEHDIAN CPED.

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	224L00000X	Pedorthist		CA

General Provider Information

NPI Number	:	1821433319
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	FRIDA JEHDIAN CPED.

Provider Business Mailing Address
First Line	:	5907 LANKERSHIM BLVD
Second Line	:
City	:	NORTH HOLLYWOOD
State	:	CA
Zip	:	91601-1006
Country	:	US
Telephone Number	:	818-980-3073
Fax Number	:	818-980-0173

Provider Business Practice Location Address
First Line	:	5907 LANKERSHIM BLVD
Second Line	:
City	:	NORTH HOLLYWOOD
State	:	CA
Zip	:	91601-1006
Country	:	US
Telephone Number	:	818-980-3073
Fax Number	:	818-980-0173

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

Provider Enumeration Date	:	05/09/2013
Last Update Date	:	05/09/2013

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Directions to “ FRIDA JEHDIAN CPED.” Practice Location

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