1275503542 NPI number — MS. SHARON LYNN FRIEDMAN MD

Table of content: MS. SHARON LYNN FRIEDMAN MD (NPI 1275503542)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1275503542 NPI number — MS. SHARON LYNN FRIEDMAN MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
FRIEDMAN
Provider First Name:
SHARON
Provider Middle Name:
LYNN
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
BORSKEY
Provider Other First Name:
SHARON
Provider Other Middle Name:
FRIEDMAN
Provider Other Name Prefix Text:
MRS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1275503542
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/07/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
25800 CARLOS BEE BLVD
Provider Second Line Business Mailing Address:
CSU EAST BAY STUDENT HEALTH SERVICES
Provider Business Mailing Address City Name:
HAYWARD
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
94542-3000
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
510-885-3735
Provider Business Mailing Address Fax Number:
510-885-3230

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
25800 CARLOS BEE BLVD
Provider Second Line Business Practice Location Address:
CSU EAST BAY STUDENT HEALTH SERVICES
Provider Business Practice Location Address City Name:
HAYWARD
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
94542-3000
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
510-885-3735
Provider Business Practice Location Address Fax Number:
510-885-3230
Provider Enumeration Date:
01/26/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 208D00000X , with the licence number:  G22120 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 00G221200 . This is a "MEDICAL" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".




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