Provider Demographics
NPI:1780911156
Name:DAVID L. FRIEDMAN A PROFESSIONAL CORPORATION
Entity type:Organization
Organization Name:DAVID L. FRIEDMAN A PROFESSIONAL CORPORATION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:LEONARD
Authorized Official - Last Name:FRIEDMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MDPHD
Authorized Official - Phone:310-337-9800
Mailing Address - Street 1:5769 UPLANDER WAY
Mailing Address - Street 2:
Mailing Address - City:CULVER CITY
Mailing Address - State:CA
Mailing Address - Zip Code:90230-6605
Mailing Address - Country:US
Mailing Address - Phone:310-337-9800
Mailing Address - Fax:310-337-0400
Practice Address - Street 1:5769 UPLANDER WAY
Practice Address - Street 2:
Practice Address - City:CULVER CITY
Practice Address - State:CA
Practice Address - Zip Code:90230-6605
Practice Address - Country:US
Practice Address - Phone:310-337-9800
Practice Address - Fax:310-337-0400
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-05
Last Update Date:2009-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG32221103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty