Individual
JASON TODD FRIEDMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
C.P.O.
Contact information
Practice address
15644 POMERADO RD, SUITE 103, POWAY, CA 92064-2400
(858) 613-0958
(858) 613-0959
Mailing address
15644 POMERADO RD, SUITE 103, POWAY, CA 92064-2400
(858) 613-0958
(858) 613-0959
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
CPO1661
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GXC000850
—
CA
Enumeration date
01/15/2008
Last updated
06/24/2010
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