Individual
THEODOR FEINSTAT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4 MEDICAL PLAZA DR, SUITE 205, ROSEVILLE, CA 95661-2815
(916) 773-6200
(916) 782-4550
Mailing address
6555 COYLE AVE, SUITE 330, CARMICHAEL, CA 95608-0303
(916) 965-9650
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
G42319
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
G42319
CA MEDICAL LICENSE
CA
01
—
ZZZ13841Z
MEDICARE ID - ROSEVILLE
CA
01
—
ZZZ13842Z
MEDICARE ID - CARMICHAEL
CA
01
—
ZZZ29516Z
MEDICARE ID - LINCOLN
CA
01
—
ZZZ43589Z
MEDICARE SUBMITTER ID
CA
Enumeration date
02/26/2007
Last updated
04/30/2008
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