Provider Demographics
NPI:1376663740
Name:FEINSTEIN, BARRY DEAN
Entity Type:Individual
Prefix:
First Name:BARRY
Middle Name:DEAN
Last Name:FEINSTEIN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:BARRY
Other - Middle Name:
Other - Last Name:FEINSTEIN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DPM
Mailing Address - Street 1:12840 RIVERSIDE DR
Mailing Address - Street 2:STE 204
Mailing Address - City:VALLEY VILLAGE
Mailing Address - State:CA
Mailing Address - Zip Code:91607-3341
Mailing Address - Country:US
Mailing Address - Phone:818-508-7922
Mailing Address - Fax:
Practice Address - Street 1:12840 RIVERSIDE DR
Practice Address - Street 2:STE 204
Practice Address - City:VALLEY VILLAGE
Practice Address - State:CA
Practice Address - Zip Code:91607-3341
Practice Address - Country:US
Practice Address - Phone:818-508-7922
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-30
Last Update Date:2008-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAE2349213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA000E23491Medicaid
CAT19187Medicare UPIN
CA000E23491Medicaid