Provider Demographics
NPI:1225014848
Name:FINNEN, NEIL PATRICK (MD)
Entity Type:Individual
Prefix:DR
First Name:NEIL
Middle Name:PATRICK
Last Name:FINNEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26520 CACTUS AVE
Mailing Address - Street 2:
Mailing Address - City:MORENO VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92555-3927
Mailing Address - Country:US
Mailing Address - Phone:951-486-4000
Mailing Address - Fax:
Practice Address - Street 1:10300 N ILLINOIS ST STE 1050
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46290-1168
Practice Address - Country:US
Practice Address - Phone:317-805-2206
Practice Address - Fax:317-817-1898
Is Sole Proprietor?:No
Enumeration Date:2005-12-15
Last Update Date:2020-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD0000034060207W00000X
IN01050629A207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN2008880960AMedicaid
IN01050629AOtherPHYSICIAN LICENSE
IN200218500Medicaid
INP00655776OtherMEDICARE RAILROAD
TNG81270Medicare UPIN
IN2008880960AMedicaid