Healthcare Provider Details
I. General information
NPI: 1770095739
Provider Name (Legal Business Name): CLIFFORD FELDMAN, MD
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/31/2017
Last Update Date: 06/26/2025
Certification Date: 06/26/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4018 ROCK HAMPTON DR
TARZANA CA
91356-5719
US
IV. Provider business mailing address
4018 ROCK HAMPTON DR
TARZANA CA
91356-5719
US
V. Phone/Fax
- Phone: 818-330-8258
- Fax: 805-584-9651
- Phone: 818-324-6979
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2084P0800X |
| Taxonomy | Psychiatry Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
KRISTA
DENNIS
Title or Position: BILLING MANAGER
Credential:
Phone: 805-579-3537