Provider Demographics
NPI:1073795266
Name:HOWARD FEIN MD INC
Entity Type:Organization
Organization Name:HOWARD FEIN MD INC
Other - Org Name:PACIFIC DERMATOLOGY SPECIALISTS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:FEIN
Authorized Official - Middle Name:
Authorized Official - Last Name:HOWARD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:310-541-7800
Mailing Address - Street 1:550 DEEP VALLEY DR
Mailing Address - Street 2:STE 287
Mailing Address - City:RLLNG HLS EST
Mailing Address - State:CA
Mailing Address - Zip Code:90274-3664
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:550 DEEP VALLEY DR
Practice Address - Street 2:STE 287
Practice Address - City:RLLNG HLS EST
Practice Address - State:CA
Practice Address - Zip Code:90274-3664
Practice Address - Country:US
Practice Address - Phone:310-541-7800
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-29
Last Update Date:2020-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA84759207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAW18140Medicare PIN