Healthcare Provider Details

I. General information

NPI: 1972063303
Provider Name (Legal Business Name): TREVOR FELDMAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/21/2019
Last Update Date: 08/04/2025
Certification Date: 08/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1514 JEFFERSON HWY
JEFFERSON LA
70121-2429
US

IV. Provider business mailing address

1514 JEFFERSON HWY
JEFFERSON LA
70121-2429
US

V. Phone/Fax

Practice location:
  • Phone: 916-734-2428
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number346433
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: