Individual provider Active NPI

David H Friedman, MD

  • MOHS-Micrographic Surgery Physician
  • Los Angeles, CA
National Provider Identifier
1841213873
Registry record updated Jan 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
MOHS-Micrographic Surgery PhysicianTaxonomy code 207ND0101X
License
G47863 Issued in CA
Practice address
10752 Ashby Ave
Los Angeles, CA 90064-3211
Phone
(310) 612-6164
Fax
(978) 288-0184
NPI assigned
Jul 25, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X G47863 CA
MOHS-Micrographic Surgery Physician 207ND0101X G47863 CA Primary

Addresses

Primary practice location

10752 Ashby Ave
Los Angeles, CA 90064-3211

Mailing address

10752 Ashby Ave
Los Angeles, CA 90064-3211
Phone (310) 612-6164

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101008000394 CA Practitioner - Dermatology 2961569538 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
47863CAMDGeneral Practice Dentistry
G47863CAMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
South Coast Dermatology Institute, a Medical Corporation Dermatology CurrentSince Aug 1, 2014 Accepting new patients
J Robert West, M.D., Inc Dermatology Past Accepting new patients

Locations

400 Newport Center Dr
Ste 602
Newport Beach, CA 92660
Phone (949) 644-1434

2552 Walnut Ave
Ste 120
Tustin, CA 92780
Phone (714) 508-0754

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1153785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642550400000",
    "number": "1841213873",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10752 ASHBY AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900643211",
            "telephone_number": "310-612-6164",
            "fax_number": "978-288-0184"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10752 ASHBY AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900643211",
            "telephone_number": "310-612-6164",
            "fax_number": "978-288-0184"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRIEDMAN",
        "first_name": "DAVID",
        "middle_name": "H",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-25",
        "last_updated": "2022-01-19",
        "certification_date": "2022-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "CA",
            "license": "G47863",
            "primary": false
        },
        {
            "code": "207ND0101X",
            "taxonomy_group": "",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "CA",
            "license": "G47863",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.