Healthcare Provider Details

I. General information

NPI: 1467541367
Provider Name (Legal Business Name): DAVID ALLEN FEINBERG M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/11/2006
Last Update Date: 03/18/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

990 SONOMA AVE STE 15
SANTA ROSA CA
95404-4813
US

IV. Provider business mailing address

121 SOTOYOME ST
SANTA ROSA CA
95405-4823
US

V. Phone/Fax

Practice location:
  • Phone: 707-525-6124
  • Fax: 707-525-6116
Mailing address:
  • Phone: 707-546-4062
  • Fax: 707-525-4097

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085B0100X
TaxonomyBody Imaging Physician
License NumberG84233
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code2085N0700X
TaxonomyNeuroradiology Physician
License NumberG84233
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code2085N0904X
TaxonomyNuclear Radiology Physician
License NumberG84233
License Number StateCA
# 4
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberG84233
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: