Provider Demographics
NPI:1841472735
Name:RONALD A. FRIEDMAN M.D. INC.
Entity type:Organization
Organization Name:RONALD A. FRIEDMAN M.D. INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:ALLEN
Authorized Official - Last Name:FRIEDMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:831-375-2486
Mailing Address - Street 1:798 CASS ST
Mailing Address - Street 2:SUITE 204
Mailing Address - City:MONTEREY
Mailing Address - State:CA
Mailing Address - Zip Code:93940-2918
Mailing Address - Country:US
Mailing Address - Phone:831-375-2486
Mailing Address - Fax:831-375-0128
Practice Address - Street 1:798 CASS ST
Practice Address - Street 2:SUITE 204
Practice Address - City:MONTEREY
Practice Address - State:CA
Practice Address - Zip Code:93940-2918
Practice Address - Country:US
Practice Address - Phone:831-375-2486
Practice Address - Fax:831-375-0128
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:RONALD A FRIEDMAN MD INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-12-03
Last Update Date:2007-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA332H00000X332H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA51370OtherUPIN
CAGR0077640Medicaid
CA00G494420Medicare UPIN