Provider Demographics
NPI:1730247982
Name:FRIEND, JOHN H (MD)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:H
Last Name:FRIEND
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:PO BOX 160327
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95816-0327
Mailing Address - Country:US
Mailing Address - Phone:916-952-2761
Mailing Address - Fax:209-745-7720
Practice Address - Street 1:1526 PLUMAS CT
Practice Address - Street 2:SUITE #300
Practice Address - City:YUBA CITY
Practice Address - State:CA
Practice Address - Zip Code:95991-2961
Practice Address - Country:US
Practice Address - Phone:916-452-2761
Practice Address - Fax:209-745-7720
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-04
Last Update Date:2015-03-26
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAA286060208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A286060Medicaid
CAAX590ZMedicare PIN
CA00A286060Medicaid