Healthcare Provider Details

I. General information

NPI: 1346510245
Provider Name (Legal Business Name): NEUFELD MEDICAL GROUP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/09/2012
Last Update Date: 01/09/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8733 BEVERLY BLVD SUITE 202
WEST HOLLYWOOD CA
90048-1827
US

IV. Provider business mailing address

8733 BEVERLY BLVD SUITE 202
WEST HOLLYWOOD CA
90048-1827
US

V. Phone/Fax

Practice location:
  • Phone: 310-652-3976
  • Fax: 310-652-8085
Mailing address:
  • Phone: 310-652-3976
  • Fax: 310-652-8085

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0205X
TaxonomyPediatric Endocrinology Physician
License NumberG029275
License Number StateCA

VIII. Authorized Official

Name: DR. NAOMI D NEUFELD
Title or Position: PRESIDENT
Credential: M.D.
Phone: 310-652-3976