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Organization

JAMES M. FEENEY MD AND DAVID A VAUGHAN MD, A PARTNERSHIP

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. JAMES MICHAEL FEENEY MD (PARTNER)
(650) 992-0463
Entity
Organization

Contact information

Practice address
1800 SULLIVAN AVE, SUITE 207, DALY CITY, CA 94015-2228
(650) 992-0463
(650) 992-8912
Mailing address
1800 SULLIVAN AVENUE, SUITE 207, DALY CITY, CA 94015-2222
(650) 992-0463
(650) 992-8912

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
A65286
CA
174400000X
Specialist
Primary
G45181
CA
174400000X
Specialist
G51966
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
CI9098
MEDICARE RAILROAD PROV #
CA
01
GR0088110
MEDI-CAL PROV ID #
CA
01
ZZZ22871Z
MEDICARE GROUP NUMBER
CA
01
ZZZ60314Z
BLUE SHIELD PROV #
CA
Enumeration date
10/12/2006
Last updated
08/22/2020
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