Provider Demographics
NPI:1730479965
Name:FRIEDMAN, ELLIOT J (DC)
Entity Type:Individual
Prefix:
First Name:ELLIOT
Middle Name:J
Last Name:FRIEDMAN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:860 E LA HABRA BLVD
Mailing Address - Street 2:SUITE 120
Mailing Address - City:LA HABRA
Mailing Address - State:CA
Mailing Address - Zip Code:90631-0815
Mailing Address - Country:US
Mailing Address - Phone:562-691-4900
Mailing Address - Fax:562-691-4300
Practice Address - Street 1:860 E LA HABRA BLVD
Practice Address - Street 2:SUITE 120
Practice Address - City:LA HABRA
Practice Address - State:CA
Practice Address - Zip Code:90631-0815
Practice Address - Country:US
Practice Address - Phone:562-691-4900
Practice Address - Fax:562-691-4300
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-08
Last Update Date:2011-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC-27759111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor