Provider Demographics
NPI:1467541367
Name:FEINBERG, DAVID ALLEN (MD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:ALLEN
Last Name:FEINBERG
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 1:121 SOTOYOME ST
Mailing Address - Street 2:
Mailing Address - City:SANTA ROSA
Mailing Address - State:CA
Mailing Address - Zip Code:95405-4823
Mailing Address - Country:US
Mailing Address - Phone:707-546-4062
Mailing Address - Fax:707-525-4097
Practice Address - Street 1:990 SONOMA AVE STE 15
Practice Address - Street 2:
Practice Address - City:SANTA ROSA
Practice Address - State:CA
Practice Address - Zip Code:95404-4813
Practice Address - Country:US
Practice Address - Phone:707-525-6124
Practice Address - Fax:707-525-6116
Is Sole Proprietor?:No
Enumeration Date:2006-10-11
Last Update Date:2013-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG842332085B0100X, 2085N0700X, 2085N0904X, 2085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
No2085B0100XAllopathic & Osteopathic PhysiciansRadiologyBody Imaging
No2085N0700XAllopathic & Osteopathic PhysiciansRadiologyNeuroradiology
No2085N0904XAllopathic & Osteopathic PhysiciansRadiologyNuclear Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G842330Medicaid
F78990Medicare UPIN
00G842330Medicare ID - Type Unspecified