Provider Demographics
NPI:1154656429
Name:MUFFELMAN, FREDDY
Entity Type:Individual
Prefix:
First Name:FREDDY
Middle Name:
Last Name:MUFFELMAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:750 GLENVIA ST APT 310
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91206-2416
Mailing Address - Country:US
Mailing Address - Phone:818-830-9500
Mailing Address - Fax:
Practice Address - Street 1:750 GLENVIA ST APT 310
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91206-2416
Practice Address - Country:US
Practice Address - Phone:818-830-9500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-10-05
Last Update Date:2009-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)