Healthcare Provider Details
I. General information
NPI: 1790724383
Provider Name (Legal Business Name): LAWRENCE HOWARD FELD MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 06/06/2006
Last Update Date: 07/11/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3700 CALIFORNIA ST
SAN FRANCISCO CA
94118-1618
US
IV. Provider business mailing address
PO BOX 39000 DEPT 33995
SAN FRANCISCO CA
94139-0001
US
V. Phone/Fax
- Phone: 415-719-0000
- Fax:
- Phone: 503-372-2740
- Fax: 503-372-2754
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207L00000X |
| Taxonomy | Anesthesiology Physician |
| License Number | G45437 |
| License Number State | CA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: