Healthcare Provider Details

I. General information

NPI: 1710228002
Provider Name (Legal Business Name): ZHANNA FELDSHER MD INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/12/2013
Last Update Date: 03/12/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1601 N SEPULVEDA BLVD SUITE 652
MANHATTAN BEACH CA
90266-5111
US

IV. Provider business mailing address

1601 N SEPULVEDA BLVD SUITE 652
MANHATTAN BEACH CA
90266-5111
US

V. Phone/Fax

Practice location:
  • Phone: 323-547-6045
  • Fax:
Mailing address:
  • Phone: 323-547-6045
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code204R00000X
TaxonomyElectrodiagnostic Medicine Physician
License NumberA110463
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License NumberA110463
License Number StateCA

VIII. Authorized Official

Name: DR. ZHANNA FELDSHER
Title or Position: OWNER
Credential: M.D.
Phone: 323-547-6045