Provider Demographics
NPI:1740372028
Name:FEINFIELD, JEFFREY K (MD)
Entity type:Individual
Prefix:
First Name:JEFFREY
Middle Name:K
Last Name:FEINFIELD
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 1:555 MARIN ST
Mailing Address - Street 2:STE 100
Mailing Address - City:THOUSAND OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91360-4102
Mailing Address - Country:US
Mailing Address - Phone:805-494-4797
Mailing Address - Fax:805-494-4810
Practice Address - Street 1:555 MARIN ST
Practice Address - Street 2:STE 100
Practice Address - City:THOUSAND OAKS
Practice Address - State:CA
Practice Address - Zip Code:91360-4102
Practice Address - Country:US
Practice Address - Phone:805-494-4797
Practice Address - Fax:805-494-4810
Is Sole Proprietor?:No
Enumeration Date:2006-09-28
Last Update Date:2017-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA71991174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAH86972Medicare UPIN
CAH86972Medicare UPIN