Provider Demographics
NPI:1326228537
Name:RONALD E FELDMAN MD INC
Entity Type:Organization
Organization Name:RONALD E FELDMAN MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:E
Authorized Official - Last Name:FELDMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:760-741-6976
Mailing Address - Street 1:488 E VALLEY PKWY STE 313
Mailing Address - Street 2:
Mailing Address - City:ESCONDIDO
Mailing Address - State:CA
Mailing Address - Zip Code:92025-3375
Mailing Address - Country:US
Mailing Address - Phone:760-741-6976
Mailing Address - Fax:760-741-2870
Practice Address - Street 1:488 E VALLEY PKWY STE 313
Practice Address - Street 2:
Practice Address - City:ESCONDIDO
Practice Address - State:CA
Practice Address - Zip Code:92025-3375
Practice Address - Country:US
Practice Address - Phone:760-741-6976
Practice Address - Fax:760-741-2870
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-06
Last Update Date:2008-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G240190Medicaid
CA00G240190Medicaid
CAW21333Medicare PIN
CAG24019Medicare PIN