Provider Demographics
NPI:1326090127
Name:FELDSHER, MENDEL JONATHAN (MD)
Entity Type:Individual
Prefix:MR
First Name:MENDEL
Middle Name:JONATHAN
Last Name:FELDSHER
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 1:3102 EAST HIGHLAND AVENUE
Mailing Address - Street 2:
Mailing Address - City:PATTON
Mailing Address - State:CA
Mailing Address - Zip Code:92369
Mailing Address - Country:US
Mailing Address - Phone:909-425-6564
Mailing Address - Fax:909-425-7955
Practice Address - Street 1:3102 EAST HIGHLAND AVENUE
Practice Address - Street 2:
Practice Address - City:PATTON
Practice Address - State:CA
Practice Address - Zip Code:92369
Practice Address - Country:US
Practice Address - Phone:909-425-6564
Practice Address - Fax:909-425-7955
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-17
Last Update Date:2009-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA640282084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
G93543Medicare UPIN
00A640281Medicare ID - Type Unspecified