MEDICARE: DR. STEFAN FELDMAN D.P.M

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	213E00000X	Podiatrist	E2430	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	953499550	OTHER	CA	TAX ID

General Provider Information

NPI Number	:	1124005137
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. STEFAN FELDMAN D.P.M

Provider Business Mailing Address
First Line	:	2121 WILSHIRE BLVD
Second Line	:	STE 101
City	:	SANTA MONICA
State	:	CA
Zip	:	90403-5742
Country	:	US
Telephone Number	:	310-828-0011
Fax Number	:	310-828-2001

Provider Business Practice Location Address
First Line	:	32144 AGOURA RD
Second Line	:	SUITE 105
City	:	WESTLAKE VILLAGE
State	:	CA
Zip	:	91361-4031
Country	:	US
Telephone Number	:	818-706-1925
Fax Number	:	818-706-1369

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/30/2005
Last Update Date	:	06/19/2018

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Directions to “ DR. STEFAN FELDMAN D.P.M” Practice Location

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