Provider Demographics
NPI:1528049475
Name:FEENEY, JOHN R (DO)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:R
Last Name:FEENEY
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Gender:M
Credentials:DO
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Mailing Address - Street 1:25405 HANCOCK AVE STE 105
Mailing Address - Street 2:
Mailing Address - City:MURRIETA
Mailing Address - State:CA
Mailing Address - Zip Code:92562-5978
Mailing Address - Country:US
Mailing Address - Phone:951-695-4688
Mailing Address - Fax:951-695-4689
Practice Address - Street 1:25405 HANCOCK AVE STE 105
Practice Address - Street 2:
Practice Address - City:MURRIETA
Practice Address - State:CA
Practice Address - Zip Code:92562
Practice Address - Country:US
Practice Address - Phone:951-695-4688
Practice Address - Fax:951-695-4689
Is Sole Proprietor?:No
Enumeration Date:2005-11-08
Last Update Date:2018-05-24
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Provider Licenses
StateLicense IDTaxonomies
CA20A6659207QA0505X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG25797Medicare UPIN