Provider Demographics
NPI:1700409810
Name:FRIEDMAN OPTOMETRY, INC.
Entity Type:Organization
Organization Name:FRIEDMAN OPTOMETRY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:STACY
Authorized Official - Middle Name:
Authorized Official - Last Name:ALVAREZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-508-0836
Mailing Address - Street 1:25317 DORIA AVE
Mailing Address - Street 2:
Mailing Address - City:LOMITA
Mailing Address - State:CA
Mailing Address - Zip Code:90717-1721
Mailing Address - Country:US
Mailing Address - Phone:310-508-0836
Mailing Address - Fax:310-559-4009
Practice Address - Street 1:10724 WASHINGTON BLVD
Practice Address - Street 2:
Practice Address - City:CULVER CITY
Practice Address - State:CA
Practice Address - Zip Code:90232-3314
Practice Address - Country:US
Practice Address - Phone:310-559-0500
Practice Address - Fax:310-559-4009
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-22
Last Update Date:2020-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1285710939OtherOPTOMETRY