Provider Demographics
NPI:1871866426
Name:EDWARD M. FELDMAN, D.O., FACOG, INC
Entity Type:Organization
Organization Name:EDWARD M. FELDMAN, D.O., FACOG, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:M
Authorized Official - Last Name:FELDMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:805-495-6331
Mailing Address - Street 1:555 MARIN STREET
Mailing Address - Street 2:SUITE 250
Mailing Address - City:THOUSAND OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91360-4106
Mailing Address - Country:US
Mailing Address - Phone:805-495-6331
Mailing Address - Fax:805-495-1606
Practice Address - Street 1:555 MARIN STREET
Practice Address - Street 2:SUITE 250
Practice Address - City:THOUSAND OAKS
Practice Address - State:CA
Practice Address - Zip Code:91360-4106
Practice Address - Country:US
Practice Address - Phone:805-495-6331
Practice Address - Fax:805-495-1606
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-13
Last Update Date:2012-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty