Individual provider Active NPI

Jeffrey Craig Friedman, M.D.

  • Ambulatory Surgical Clinic/Center
  • Lafayette, CA
National Provider Identifier
1598979734
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
License
G 46244 Issued in CA
Practice address
911 Moraga Rd Ste 205
Lafayette, CA 94549-4500
Phone
(925) 283-4012
Fax
(925) 283-4847
NPI assigned
May 9, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X G 46244 CA Primary

Addresses

Primary practice location

911 Moraga Rd Ste 205
Lafayette, CA 94549-4500

Mailing address

12074 Broadway Ter
Oakland, CA 94611-1957
Phone (510) 450-0543

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
G 46244CAMDAmbulatory Surgical Clinic/Center

NPI Registry JSON

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

{
    "created_epoch": "1178668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1598979734",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12074 BROADWAY TER",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946111957",
            "telephone_number": "510-450-0543"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "911 MORAGA RD STE 205",
            "city": "LAFAYETTE",
            "state": "CA",
            "postal_code": "945494500",
            "telephone_number": "925-283-4012",
            "fax_number": "925-283-4847"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRIEDMAN",
        "first_name": "JEFFREY",
        "middle_name": "CRAIG",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-09",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "CA",
            "license": "G 46244",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lafayette, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.