Provider Demographics
NPI:1831383082
Name:FRIEDMAN, BRADLEY J (MD)
Entity type:Individual
Prefix:DR
First Name:BRADLEY
Middle Name:J
Last Name:FRIEDMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:BRADLEY
Other - Middle Name:
Other - Last Name:FRIEDMAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:11613 W PICO BLVD
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90064-2908
Mailing Address - Country:US
Mailing Address - Phone:310-268-2288
Mailing Address - Fax:310-268-1553
Practice Address - Street 1:11613 W PICO BLVD
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90064-2908
Practice Address - Country:US
Practice Address - Phone:310-268-2288
Practice Address - Fax:310-268-1553
Is Sole Proprietor?:No
Enumeration Date:2007-08-30
Last Update Date:2021-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG077646207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine