Healthcare Provider Details

I. General information

NPI: 1104157601
Provider Name (Legal Business Name): ZHANNA FELDSHER M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/22/2010
Last Update Date: 08/25/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2928 E CESAR E CHAVEZ AVE
LOS ANGELES CA
90033-3110
US

IV. Provider business mailing address

PO BOX 848 1601 N SEPULVEDA BLVD
MANHATTAN BEACH CA
90267-0848
US

V. Phone/Fax

Practice location:
  • Phone: 323-266-6700
  • Fax: 323-266-7161
Mailing address:
  • Phone: 310-822-3524
  • Fax: 310-822-3524

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License NumberA110463
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA110463
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: