Provider Demographics
NPI:1053418640
Name:FELTMAN, JOAN KAREN (MD)
Entity type:Individual
Prefix:DR
First Name:JOAN
Middle Name:KAREN
Last Name:FELTMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:JOAN
Other - Middle Name:FELTMAN
Other - Last Name:SCHWARTZ
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:2021 SANTA MONICA BLVD
Mailing Address - Street 2:SUITE 710
Mailing Address - City:SANTA MONICA
Mailing Address - State:CA
Mailing Address - Zip Code:90404-2208
Mailing Address - Country:US
Mailing Address - Phone:310-315-0131
Mailing Address - Fax:310-453-0133
Practice Address - Street 1:2021 SANTA MONICA BLVD
Practice Address - Street 2:SUITE 710
Practice Address - City:SANTA MONICA
Practice Address - State:CA
Practice Address - Zip Code:90404-2208
Practice Address - Country:US
Practice Address - Phone:310-315-0131
Practice Address - Fax:310-453-0133
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG23409207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAF40641Medicare UPIN