Provider Demographics
NPI:1720127772
Name:FRIEDLAND, MIRIAM HANNAH (MD)
Entity Type:Individual
Prefix:DR
First Name:MIRIAM
Middle Name:HANNAH
Last Name:FRIEDLAND
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:MIRIAM
Other - Middle Name:HANNAH
Other - Last Name:NOSSEL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:828 S BASCOM AVE
Mailing Address - Street 2:100
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95128-2601
Mailing Address - Country:US
Mailing Address - Phone:408-793-5959
Mailing Address - Fax:408-793-5955
Practice Address - Street 1:828 S BASCOM AVE
Practice Address - Street 2:100
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95128-2651
Practice Address - Country:US
Practice Address - Phone:408-793-5870
Practice Address - Fax:408-275-6716
Is Sole Proprietor?:No
Enumeration Date:2007-02-06
Last Update Date:2013-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA257992084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAGL380UMedicare PIN
CAGL380TMedicare PIN
CAGL380SMedicare PIN
CAGL380RMedicare PIN
CAGL380WMedicare PIN
CAGL380VMedicare PIN
CAGL380Medicare PIN
CAGL380XMedicare PIN
CAF46130Medicare UPIN
CAGL380PMedicare PIN
CAGL380QMedicare PIN
CAGL380ZMedicare PIN
CAGL380YMedicare PIN
00A257990Medicare PIN