Provider Demographics
NPI:1538478110
Name:MICHAEL F FELONG MD PHD & DOLORES I SWEENEY DO MEDICAL PARTNERSHIP
Entity Type:Organization
Organization Name:MICHAEL F FELONG MD PHD & DOLORES I SWEENEY DO MEDICAL PARTNERSHIP
Other - Org Name:MICHAEL F. FELONG M.D., PH.D.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:FRANCIS
Authorized Official - Last Name:FELONG
Authorized Official - Suffix:
Authorized Official - Credentials:MD, PHD
Authorized Official - Phone:951-699-4511
Mailing Address - Street 1:29645 RANCHO CALIFORNIA ROAD
Mailing Address - Street 2:SUITE 217
Mailing Address - City:TEMECULA
Mailing Address - State:CA
Mailing Address - Zip Code:92591
Mailing Address - Country:US
Mailing Address - Phone:951-699-5411
Mailing Address - Fax:951-695-5285
Practice Address - Street 1:29645 RANCHO CALIFORNIA ROAD
Practice Address - Street 2:SUITE 217
Practice Address - City:TEMECULA
Practice Address - State:CA
Practice Address - Zip Code:92591
Practice Address - Country:US
Practice Address - Phone:951-699-4511
Practice Address - Fax:951-695-5285
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-30
Last Update Date:2014-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG51366207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G51366Medicaid
CA00G51366Medicaid
A51978Medicare UPIN
CA00G513660Medicare PIN
00G513660Medicare PIN