NPIMap

Organization Active NPI

Mark a. Friedman, M.D., Inc.

  • Specialist
  • Sebastopol, CA
National Provider Identifier
1114276664
Registry record updated Mar 17, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
C55315 Issued in CA
Legal business name
MARK A. FRIEDMAN, M.D., INC.
Practice address
6260 Vine Hill Rd
Sebastopol, CA 95472-2050
Phone
(253) 514-2472
NPI assigned
Aug 30, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Mark Alan Friedman, M.D.
Title
Ceo/Physician
Phone
(253) 514-2472

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X C55315 CA Primary

Addresses

Primary practice location

6260 Vine Hill Rd
Sebastopol, CA 95472-2050

Mailing address

6260 Vine Hill Rd
Sebastopol, CA 95472-2050
Phone (253) 514-2472

National Provider Directory

National Provider Directory

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1346284800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1426550400000",
    "number": "1114276664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6260 VINE HILL RD",
            "city": "SEBASTOPOL",
            "state": "CA",
            "postal_code": "954722050",
            "telephone_number": "253-514-2472"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6260 VINE HILL RD",
            "city": "SEBASTOPOL",
            "state": "CA",
            "postal_code": "954722050",
            "telephone_number": "253-514-2472"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARK A. FRIEDMAN, M.D., INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-08-30",
        "last_updated": "2015-03-17",
        "status": "A",
        "authorized_official_last_name": "FRIEDMAN",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "ALAN",
        "authorized_official_title_or_position": "CEO/PHYSICIAN",
        "authorized_official_telephone_number": "253-514-2472",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "CA",
            "license": "C55315",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sebastopol, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.