MEDICARE: DR. LAWRENCE DAVID FREEDMAN 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	207Q00000X	Family Medicine Physician	GFE6213	CA

General Provider Information

NPI Number	:	1861783029
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LAWRENCE DAVID FREEDMAN M.D.

Provider Business Mailing Address
First Line	:	2110 YACHT MISCHIEF
Second Line	:
City	:	NEWPORT BEACH
State	:	CA
Zip	:	92660-6714
Country	:	US
Telephone Number	:	949-720-0479
Fax Number	:	949-720-0479

Provider Business Practice Location Address
First Line	:	2110 YACHT MISCHIEF
Second Line	:
City	:	NEWPORT BEACH
State	:	CA
Zip	:	92660-6714
Country	:	US
Telephone Number	:	949-720-0479
Fax Number	:	949-720-0479

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

Provider Enumeration Date	:	04/22/2011
Last Update Date	:	04/22/2011

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