Basic Information
Provider Information
NPI: 1710193636
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: FEIGENBAUM
FirstName: STEVE
MiddleName:  
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Mailing Information
Address1: 1904 SO. ROBERTSON BLVD.
Address2:  
City: LOS ANGELES
State: CA
PostalCode: 90034
CountryCode: US
TelephoneNumber: 3108387747
FaxNumber:  
Practice Location
Address1: 6055 E. WASHINGTON BLVD.
Address2: SUITE 900
City: COMMERCE
State: CA
PostalCode: 90040
CountryCode: US
TelephoneNumber: 3233460960
FaxNumber: 3233460966
Other Information
ProviderEnumerationDate: 05/15/2007
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
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NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
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IsSoleProprietor: N
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NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225400000X  Y Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner 

No ID Information.


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