Healthcare Provider Details

I. General information

NPI: 1437218575
Provider Name (Legal Business Name): BARRY JAY FEINBERG M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/06/2006
Last Update Date: 03/29/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12021 WILSHIRE BLVD STE 745
LOS ANGELES CA
90025-1206
US

IV. Provider business mailing address

12021 WILSHIRE BLVD STE 745
LOS ANGELES CA
90025-1206
US

V. Phone/Fax

Practice location:
  • Phone: 310-348-1900
  • Fax:
Mailing address:
  • Phone: 310-348-1900
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207YX0905X
TaxonomyOtolaryngology/Facial Plastic Surgery Physician
License NumberA24225
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: