Provider Demographics
NPI:1679537203
Name:BAY PSYCHIATRIC MEDICAL GROUP
Entity Type:Organization
Organization Name:BAY PSYCHIATRIC MEDICAL GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:CLAUDE
Authorized Official - Middle Name:TH
Authorized Official - Last Name:FRIEDMANN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:310-373-0527
Mailing Address - Street 1:23326 HAWTHORNE BLVD
Mailing Address - Street 2:SUITE #375
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90505-3725
Mailing Address - Country:US
Mailing Address - Phone:310-373-0527
Mailing Address - Fax:310-373-6915
Practice Address - Street 1:23326 HAWTHORNE BLVD
Practice Address - Street 2:SUITE #375
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90505-3725
Practice Address - Country:US
Practice Address - Phone:310-373-0527
Practice Address - Fax:310-373-6915
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-12
Last Update Date:2008-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAW9172Medicare PIN