Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207KA0200X | Allergist | G53565 | CA |
NPI | 1457345225 |
---|---|
Provider Name | Bruce F Friedman |
First Address | Fountain Valley, CA 92708-7501 |
Second Address | Fountain Valley, CA 92708-7501 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/09/2005 |
Last Update Date | 01/06/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
A52550 | (02) | CA |