Provider Demographics
NPI:1013900182
Name:FEINFIELD, ROBERT EVAN (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:EVAN
Last Name:FEINFIELD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:2625 W ALAMEDA AVE
Mailing Address - Street 2:208
Mailing Address - City:BURBANK
Mailing Address - State:CA
Mailing Address - Zip Code:91505-4806
Mailing Address - Country:US
Mailing Address - Phone:818-845-3557
Mailing Address - Fax:818-845-2600
Practice Address - Street 1:2625 W ALAMEDA AVE
Practice Address - Street 2:208
Practice Address - City:BURBANK
Practice Address - State:CA
Practice Address - Zip Code:91505-4806
Practice Address - Country:US
Practice Address - Phone:818-845-3557
Practice Address - Fax:818-845-2600
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG48218207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G482180Medicaid
CA00G482180Medicaid
CAWG48128AMedicare ID - Type Unspecified
CAWG48218BMedicare ID - Type Unspecified