Provider Demographics
NPI:1013047455
Name:JEFFREY FEINFIELD, M.D. INC
Entity Type:Organization
Organization Name:JEFFREY FEINFIELD, M.D. INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:KENT
Authorized Official - Last Name:FEINFIELD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:805-494-4797
Mailing Address - Street 1:415 ROLLING OAKS DR
Mailing Address - Street 2:SUITE 190
Mailing Address - City:THOUSAND OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91361-1029
Mailing Address - Country:US
Mailing Address - Phone:805-494-4797
Mailing Address - Fax:805-494-4810
Practice Address - Street 1:415 ROLLING OAKS DR
Practice Address - Street 2:SUITE 190
Practice Address - City:THOUSAND OAKS
Practice Address - State:CA
Practice Address - Zip Code:91361-1029
Practice Address - Country:US
Practice Address - Phone:805-494-4797
Practice Address - Fax:805-494-4810
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-06
Last Update Date:2018-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA=========OtherTAX ID #
CAH86972Medicare UPIN