Healthcare Provider Details

I. General information

NPI: 1710063243
Provider Name (Legal Business Name): PAUL A. FEIGENBAUM MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/27/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1950 FRANKLIN ST
OAKLAND CA
94612-5103
US

IV. Provider business mailing address

1800 HARRISON ST FL 7
OAKLAND CA
94612-3429
US

V. Phone/Fax

Practice location:
  • Phone: 510-987-1000
  • Fax:
Mailing address:
  • Phone: 510-625-6262
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License NumberG33646
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: