Provider Demographics
NPI:1457368649
Name:FEILER, LEWIS SCOTT (MD)
Entity Type:Individual
Prefix:DR
First Name:LEWIS
Middle Name:SCOTT
Last Name:FEILER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:162 CLINTON ST
Mailing Address - Street 2:
Mailing Address - City:REDWOOD CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94062-1552
Mailing Address - Country:US
Mailing Address - Phone:650-369-2529
Mailing Address - Fax:650-369-5400
Practice Address - Street 1:162 CLINTON ST
Practice Address - Street 2:
Practice Address - City:REDWOOD CITY
Practice Address - State:CA
Practice Address - Zip Code:94062-1552
Practice Address - Country:US
Practice Address - Phone:650-369-2529
Practice Address - Fax:650-369-5400
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-01
Last Update Date:2008-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG32622174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G326220Medicaid
CAA89529Medicare UPIN
CA00G326220Medicare PIN
CA00G326220Medicaid