Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207N00000X | Dermatologist | G64842 | CA |
N | 207ND0101X | MOHS-Micrographic Surgeon | G64842 | CA |
N | 207NP0225X | Pediatric Dermatologist | G64842 | CA |
N | 207NS0135X | Procedural Dermatology | G64842 | CA |
NPI | 1235148735 |
---|---|
Provider Name | Sheri G Feldman |
First Address | Beverly Hills, CA 90210-4532 |
Second Address | Beverly Hills, CA 90210-4532 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/08/2006 |
Last Update Date | 21/10/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
E74643 | (02) | CA |
G64842 | CALIFORNIA STATE LICENSE (01) | CA |