Provider Demographics
NPI:1932116092
Name:FEISS, ROBERT EMERSON (MD)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:EMERSON
Last Name:FEISS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:ROBERT
Other - Middle Name:EMERSON
Other - Last Name:FEISS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:910 EL TORO RD
Mailing Address - Street 2:
Mailing Address - City:OJAI
Mailing Address - State:CA
Mailing Address - Zip Code:93023-1713
Mailing Address - Country:US
Mailing Address - Phone:805-758-7408
Mailing Address - Fax:
Practice Address - Street 1:910 EL TORO RD
Practice Address - Street 2:
Practice Address - City:OJAI
Practice Address - State:CA
Practice Address - Zip Code:93023-1713
Practice Address - Country:US
Practice Address - Phone:805-758-7408
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-02
Last Update Date:2017-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG48219208D00000X, 207QG0300X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric Medicine
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG48219Medicare PIN
CAA50974Medicare UPIN