Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208800000X | Urologist | G21974 | CA |
NPI | 1023048501 |
---|---|
Provider Name | William Eugene Friedel |
First Address | La Mesa, CA 92584 |
Second Address | La Mesa, CA 91942-3017 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/07/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
A41442 | (02) | CA |
GR0071060 | (05) | CA |