Provider Demographics
NPI:1306953021
Name:FREIMANN, JACK (MD)
Entity type:Individual
Prefix:
First Name:JACK
Middle Name:
Last Name:FREIMANN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:11480 BROOKSHIRE AVE
Mailing Address - Street 2:SUITE 309
Mailing Address - City:DOWNEY
Mailing Address - State:CA
Mailing Address - Zip Code:90241-5018
Mailing Address - Country:US
Mailing Address - Phone:562-869-1201
Mailing Address - Fax:562-869-1281
Practice Address - Street 1:8135 PAINTER AVE
Practice Address - Street 2:SUITE 103
Practice Address - City:WHITTIER
Practice Address - State:CA
Practice Address - Zip Code:90602-3158
Practice Address - Country:US
Practice Address - Phone:562-698-6888
Practice Address - Fax:562-698-5855
Is Sole Proprietor?:No
Enumeration Date:2006-08-25
Last Update Date:2013-07-24
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAG58179174400000X, 207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAE79358Medicare UPIN