MEDICARE: DR. MITCHELL L FEINGOLD D.P.M.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	213E00000X	Podiatrist	E-1436	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1568404572
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MITCHELL L FEINGOLD D.P.M.

Provider Business Mailing Address
First Line	:	5580 LA JOLLA BLVD
Second Line	:	#419
City	:	LA JOLLA
State	:	CA
Zip	:	92037-7651
Country	:	US
Telephone Number	:	858-550-8110
Fax Number	:	858-550-8087

Provider Business Practice Location Address
First Line	:	2306 6TH AVE
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92101-1643
Country	:	US
Telephone Number	:	858-550-8110
Fax Number	:	858-550-8087

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/12/2006
Last Update Date	:	04/09/2008

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