Healthcare Provider Details

I. General information

NPI: 1003210006
Provider Name (Legal Business Name): STEVEN MITCHELL FEINGOLD D.C
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/20/2014
Last Update Date: 10/20/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2900 BRISTOL ST C105
COSTA MESA CA
92626-5981
US

IV. Provider business mailing address

2900 BRISTOL ST C105
COSTA MESA CA
92626-5981
US

V. Phone/Fax

Practice location:
  • Phone: 714-557-9454
  • Fax:
Mailing address:
  • Phone: 714-557-9454
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number24126
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: