Provider Demographics
NPI:1235148735
Name:FELDMAN, SHERI G (MD)
Entity Type:Individual
Prefix:
First Name:SHERI
Middle Name:G
Last Name:FELDMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:414 N CAMDEN DR
Mailing Address - Street 2:SUITE 640
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90210-4532
Mailing Address - Country:US
Mailing Address - Phone:310-271-7400
Mailing Address - Fax:310-271-0003
Practice Address - Street 1:414 N CAMDEN DR
Practice Address - Street 2:SUITE 640
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90210-4532
Practice Address - Country:US
Practice Address - Phone:310-271-7400
Practice Address - Fax:310-271-0003
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-05
Last Update Date:2008-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG64842207N00000X, 207ND0101X, 207NP0225X, 207NS0135X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
No207ND0101XAllopathic & Osteopathic PhysiciansDermatologyMOHS-Micrographic Surgery
No207NP0225XAllopathic & Osteopathic PhysiciansDermatologyPediatric Dermatology
No207NS0135XAllopathic & Osteopathic PhysiciansDermatologyProcedural Dermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG64842OtherCALIFORNIA STATE LICENSE
CAG64842OtherCALIFORNIA STATE LICENSE
CAE74643Medicare UPIN