Provider Demographics
NPI:1689685216
Name:FEINBERG, ANDREA TIZES (MD)
Entity Type:Individual
Prefix:DR
First Name:ANDREA
Middle Name:TIZES
Last Name:FEINBERG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:9201 W SUNSET BLVD
Mailing Address - Street 2:SUITE 701
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90069-3701
Mailing Address - Country:US
Mailing Address - Phone:310-855-2558
Mailing Address - Fax:888-747-2520
Practice Address - Street 1:9201 SUNSET BLVD
Practice Address - Street 2:SUITE 701
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90069
Practice Address - Country:US
Practice Address - Phone:310-855-2558
Practice Address - Fax:888-747-2520
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-10
Last Update Date:2013-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAGO74644207RC0200X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
G30762Medicare UPIN