Provider Demographics
NPI:1144551854
Name:ROBERT FELT, M.D., INC.
Entity type:Organization
Organization Name:ROBERT FELT, M.D., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT-CORP.
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:FELT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:818-788-8151
Mailing Address - Street 1:4955 VAN NUYS BLVD
Mailing Address - Street 2:STE 322
Mailing Address - City:SHERMAN OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91403-1822
Mailing Address - Country:US
Mailing Address - Phone:818-788-8151
Mailing Address - Fax:818-789-1660
Practice Address - Street 1:4955 VAN NUYS BLVD
Practice Address - Street 2:STE 322
Practice Address - City:SHERMAN OAKS
Practice Address - State:CA
Practice Address - Zip Code:91403-1822
Practice Address - Country:US
Practice Address - Phone:818-788-8151
Practice Address - Fax:818-789-1660
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ROBERT FELT, M.D., INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-01-20
Last Update Date:2010-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA28160207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty