MEDICARE: DR. D. TODD FEELEY M.D.

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	2084P0800X	Psychiatry Physician	G75366	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

General Provider Information

NPI Number	:	1548351158
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. D. TODD FEELEY M.D.

Provider Business Mailing Address
First Line	:	1950 ALAMEDA DE LAS PULGAS
Second Line	:
City	:	SAN MATEO
State	:	CA
Zip	:	94403-1222
Country	:	US
Telephone Number	:	650-573-3571
Fax Number	:	650-572-9347

Provider Business Practice Location Address
First Line	:	1950 ALAMEDA DE LAS PULGAS
Second Line	:
City	:	SAN MATEO
State	:	CA
Zip	:	94403-1222
Country	:	US
Telephone Number	:	650-573-3571
Fax Number	:	650-572-9347

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

Provider Enumeration Date	:	09/27/2006
Last Update Date	:	11/20/2020

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