MEDICARE: HARRY DAVID FRIEDMAN DO

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	208D00000X	General Practice Physician	20A5876	CA

General Provider Information

NPI Number	:	1881866812
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HARRY DAVID FRIEDMAN DO

Provider Business Mailing Address
First Line	:	3097 MOORPARK AVENUE
Second Line	:	SUITE 102
City	:	SAN JOSE
State	:	CA
Zip	:	95128
Country	:	US
Telephone Number	:	408-247-1169
Fax Number	:	408-300-5076

Provider Business Practice Location Address
First Line	:	3097 MOORPARK AVE
Second Line	:	SUITE 102
City	:	SAN JOSE
State	:	CA
Zip	:	95128-2543
Country	:	US
Telephone Number	:	408-247-1169
Fax Number	:	408-300-5076

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

Provider Enumeration Date	:	03/31/2008
Last Update Date	:	10/25/2010

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