Provider Demographics
NPI:1528434107
Name:FELDMAN, RICHARD L (CPO)
Entity type:Individual
Prefix:
First Name:RICHARD
Middle Name:L
Last Name:FELDMAN
Suffix:
Gender:M
Credentials:CPO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5422 QUAKERTOWN AVE
Mailing Address - Street 2:APT 102
Mailing Address - City:WOODLAND HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91364-2507
Mailing Address - Country:US
Mailing Address - Phone:805-714-5468
Mailing Address - Fax:
Practice Address - Street 1:5422 QUAKERTOWN AVE
Practice Address - Street 2:APT 102
Practice Address - City:WOODLAND HILLS
Practice Address - State:CA
Practice Address - Zip Code:91364-2507
Practice Address - Country:US
Practice Address - Phone:805-714-5468
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-18
Last Update Date:2015-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CACPO00922222Z00000X, 224P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotist
No224P00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersProsthetist