Provider Demographics
NPI:1932201787
Name:FEIWELL, LAWRENCE ALLEN (MD)
Entity Type:Individual
Prefix:DR
First Name:LAWRENCE
Middle Name:ALLEN
Last Name:FEIWELL
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 1:3742 KATELLA AVE
Mailing Address - Street 2:SUITE 401
Mailing Address - City:LOS ALAMITOS
Mailing Address - State:CA
Mailing Address - Zip Code:90720-3102
Mailing Address - Country:US
Mailing Address - Phone:562-431-4800
Mailing Address - Fax:562-431-4813
Practice Address - Street 1:3742 KATELLA AVE
Practice Address - Street 2:SUITE 401
Practice Address - City:LOS ALAMITOS
Practice Address - State:CA
Practice Address - Zip Code:90720-3102
Practice Address - Country:US
Practice Address - Phone:562-431-4800
Practice Address - Fax:562-431-4813
Is Sole Proprietor?:No
Enumeration Date:2006-09-02
Last Update Date:2020-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG59223207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG59223OtherMEDICAL LICENSE
CAG59223OtherCA MEDICAL LICENSE
CA00G592230Medicaid
CAWG59223EMedicare PIN
CA0226020002Medicare NSC
WG59223EMedicare PIN
E88798Medicare UPIN
CA00G592230Medicaid
0226020002Medicare NSC
WG59223DMedicare Oscar/Certification
CAWG59223DMedicare PIN