Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YX0007X | Plastic Surgeon (Head & Neck) | G58691 | CA |
NPI | 1730187881 |
---|---|
Provider Name | Gary Mitchell Feinberg |
First Address | Moreno Valley, CA 92552-7270 |
Second Address | Riverside, CA 92506 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/07/2005 |
Last Update Date | 04/08/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
E88660 | (02) | CA |