Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080A0000X | Adolescent Medicine | C23871 | CA |
NPI | 1225064371 |
---|---|
Provider Name | Dr. Paul Feldheim |
First Address | Ventura, CA 93003-2619 |
Second Address | Ventura, CA 93003-8400 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/06/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
A32504 | (02) | CA |