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General NPI Number Information
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NPI Number | 1639294697
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Entity Type | Individual
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Provider Name | TERRY KENT FEIGENBAUM O.D.
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Gender | Male
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Dates
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Enumeration Date | 03/20/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1545 WESTWOOD BLVD.
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City | LOS ANGELES
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State | CA
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Zip | 90024
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Country | US
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Telephone | 310-477-0677
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Fax | 310-477-1677
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Provider Business Mailing Address
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Address Line | 3167 CAVENDISH DR.
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City | LOS ANGELES
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State | CA
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Zip | 90064
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Country | US
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Telephone | 310-837-2020
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Fax | 310-559-5966
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 04422T
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License Number State | CA
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