Provider Demographics
NPI:1609800242
Name:FRIEDMAN PROFESSIONAL MANAGEMENT CO
Entity Type:Organization
Organization Name:FRIEDMAN PROFESSIONAL MANAGEMENT CO
Other - Org Name:FOUR SEASONS SURGERY CENTERS OF HUNTINGTON BEACH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE ASSISTANT
Authorized Official - Prefix:
Authorized Official - First Name:VENUS
Authorized Official - Middle Name:
Authorized Official - Last Name:BRINKMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:909-260-9890
Mailing Address - Street 1:17752 BEACH BLVD
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92647-6838
Mailing Address - Country:US
Mailing Address - Phone:714-842-1426
Mailing Address - Fax:
Practice Address - Street 1:17752 BEACH BLVD
Practice Address - Street 2:
Practice Address - City:HUNTINGTON BEACH
Practice Address - State:CA
Practice Address - Zip Code:92647-6838
Practice Address - Country:US
Practice Address - Phone:714-842-1426
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-10
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZT11786FOtherMEDICAL NUMBER
CAS05-1000Medicare Oscar/Certification