MEDICARE: DR. BERNARD A FEIGENBAUM 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	207K00000X	Allergy & Immunology Physician	5332910	NY
2	207K00000X	Allergy & Immunology Physician	G69281	CA

General Provider Information

NPI Number	:	1639115652
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BERNARD A FEIGENBAUM M.D.

Provider Business Mailing Address
First Line	:	9850 GENESEE AVE
Second Line	:	355
City	:	LA JOLLA
State	:	CA
Zip	:	92037-1224
Country	:	US
Telephone Number	:	619-291-5800
Fax Number	:

Provider Business Practice Location Address
First Line	:	191 SAND CREEK RD STE 125
Second Line	:
City	:	BRENTWOOD
State	:	CA
Zip	:	94513-2216
Country	:	US
Telephone Number	:	415-362-5443
Fax Number	:

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

Provider Enumeration Date	:	06/20/2006
Last Update Date	:	04/13/2026

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