Provider Demographics
NPI:1659542405
Name:FRIEND, LARAINE JOYCE SMITH (MD)
Entity Type:Individual
Prefix:
First Name:LARAINE
Middle Name:JOYCE SMITH
Last Name:FRIEND
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:46057 OASIS ST
Mailing Address - Street 2:
Mailing Address - City:INDIO
Mailing Address - State:CA
Mailing Address - Zip Code:92201-5906
Mailing Address - Country:US
Mailing Address - Phone:760-863-8818
Mailing Address - Fax:760-863-8968
Practice Address - Street 1:46057 OASIS ST
Practice Address - Street 2:
Practice Address - City:INDIO
Practice Address - State:CA
Practice Address - Zip Code:92201-5906
Practice Address - Country:US
Practice Address - Phone:760-863-8818
Practice Address - Fax:760-863-8968
Is Sole Proprietor?:No
Enumeration Date:2008-03-20
Last Update Date:2008-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG54255207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine