Provider Demographics
NPI:1376967653
Name:FRIEDMAN, ALEX DAVID (PA-C)
Entity Type:Individual
Prefix:
First Name:ALEX
Middle Name:DAVID
Last Name:FRIEDMAN
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:77 VAN NESS AVE
Mailing Address - Street 2:SUITE 302
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94102-6041
Mailing Address - Country:US
Mailing Address - Phone:415-379-9015
Mailing Address - Fax:415-379-9045
Practice Address - Street 1:77 VAN NESS AVE
Practice Address - Street 2:SUITE 302
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94102-6041
Practice Address - Country:US
Practice Address - Phone:415-379-9015
Practice Address - Fax:415-379-9045
Is Sole Proprietor?:No
Enumeration Date:2014-02-07
Last Update Date:2014-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA51418363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical