Provider Demographics
NPI:1336210707
Name:FREEDMAN, M.D., GARY (GARY FREEDMAN, MD)
Entity Type:Individual
Prefix:DR
First Name:GARY
Middle Name:
Last Name:FREEDMAN, M.D.
Suffix:
Gender:M
Credentials:GARY FREEDMAN, MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3530 LAS PASAS WAY
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95864-2820
Mailing Address - Country:US
Mailing Address - Phone:818-435-4751
Mailing Address - Fax:
Practice Address - Street 1:MITZPE NETOFA
Practice Address - Street 2:1137
Practice Address - City:D.N. LOWER GALILEE
Practice Address - State:GALIL
Practice Address - Zip Code:15295
Practice Address - Country:IL
Practice Address - Phone:04-678-9215
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA412202084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry