MEDICARE: JEFFREY FELGNER MD, P.C.

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	207QG0300X	Geriatric Medicine (Family Medicine) Physician

General Provider Information

NPI Number	:	1730759754
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JEFFREY FELGNER MD, P.C.

Provider Business Mailing Address
First Line	:	1998 ORANGE AVE
Second Line	:
City	:	COSTA MESA
State	:	CA
Zip	:	92627-2238
Country	:	US
Telephone Number	:	858-735-6258
Fax Number	:

Provider Business Practice Location Address
First Line	:	1998 ORANGE AVE
Second Line	:
City	:	COSTA MESA
State	:	CA
Zip	:	92627-2238
Country	:	US
Telephone Number	:	858-735-6258
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. JEFFREY STEVEN FELGNER
Credential	:	MD
Telephone Number	:	858-735-6258

Provider Enumeration Date	:	06/30/2021
Last Update Date	:	06/30/2021

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