Individual provider Active NPI

Theodore Friedmann, M.D.

  • Children's Hospital
  • La Jolla, CA
National Provider Identifier
1174778500
Registry record updated Nov 26, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Children's HospitalTaxonomy code 282NC2000X
License
G20127 Issued in CA
Practice address
9500 Gilman Drive
La Jolla, CA 92093-0634
Phone
(858) 534-4268
Fax
(858) 534-1422
NPI assigned
Nov 26, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 26, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Children's Hospital 282NC2000X G20127 CA Primary

Addresses

Primary practice location

9500 Gilman Drive
La Jolla, CA 92093-0634

Mailing address

9470 La Jolla Shores Dr
La Jolla, CA 92037-1137
Phone (858) 535-9678

Other identifiers 1

IdentifierTypeStateIssuer
274271OtherCAUNIVERSITY EMPLOYEE NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
G20127CAMDChildren's Hospital

NPI Registry JSON

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

{
    "created_epoch": "1227657600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1227657600000",
    "number": "1174778500",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9470 LA JOLLA SHORES DR",
            "city": "LA JOLLA",
            "state": "CA",
            "postal_code": "920371137",
            "telephone_number": "858-535-9678"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9500 GILMAN DRIVE",
            "city": "LA JOLLA",
            "state": "CA",
            "postal_code": "920930634",
            "telephone_number": "858-534-4268",
            "fax_number": "858-534-1422"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRIEDMANN",
        "first_name": "THEODORE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-11-26",
        "last_updated": "2008-11-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "282NC2000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Children",
            "state": "CA",
            "license": "G20127",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNIVERSITY EMPLOYEE NUMBER",
            "identifier": "274271",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in La Jolla, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2008; 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.