Provider Demographics
NPI:1841674363
Name:WESTERN UNIVERSITY OF HEALTH SCIENCES
Entity type:Organization
Organization Name:WESTERN UNIVERSITY OF HEALTH SCIENCES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DEAN
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:WILLIAM
Authorized Official - Last Name:FRIEDRICHSEN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:909-706-3504
Mailing Address - Street 1:795 E 2ND ST # 8
Mailing Address - Street 2:
Mailing Address - City:POMONA
Mailing Address - State:CA
Mailing Address - Zip Code:91766-2007
Mailing Address - Country:US
Mailing Address - Phone:909-706-3943
Mailing Address - Fax:909-469-8650
Practice Address - Street 1:71949 HIGHWAY 111
Practice Address - Street 2:
Practice Address - City:RANCHO MIRAGE
Practice Address - State:CA
Practice Address - Zip Code:92270-4826
Practice Address - Country:US
Practice Address - Phone:909-706-3943
Practice Address - Fax:909-469-8650
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:WESTERN UNIVERSITY OF HEALTH SCIENCES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-07-14
Last Update Date:2015-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental