Provider Demographics
NPI:1376967653
Name:FRIEDMAN, ALEX DAVID (PA-C)
Entity type:Individual
Prefix:
First Name:ALEX
Middle Name:DAVID
Last Name:FRIEDMAN
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:575 SIR FRANCIS DRAKE BLVD STE 1
Mailing Address - Street 2:
Mailing Address - City:GREENBRAE
Mailing Address - State:CA
Mailing Address - Zip Code:94904-2307
Mailing Address - Country:US
Mailing Address - Phone:415-625-3230
Mailing Address - Fax:
Practice Address - Street 1:575 SIR FRANCIS DRAKE BLVD STE 1
Practice Address - Street 2:
Practice Address - City:GREENBRAE
Practice Address - State:CA
Practice Address - Zip Code:94904-2307
Practice Address - Country:US
Practice Address - Phone:415-625-3230
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-02-07
Last Update Date:2025-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPA.0008275363AS0400X
TXPA18062363AS0400X
CA51418363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical