| Doctor Name: | DR. MYRA LEE FEFFER |
| NPI Number: | 1730270331 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | M.D. |
| License Number: | GI2306 |
| Business Practice Address: | 16111 Plummer St Sepulveda, CA - 913432036 |
| Business Phone Number: | 8188917711 |
| Business Fax Number: | |
| Mailing Address: | 2670 Basil Ln, LOS ANGELES |
| State: | CA |
| Postal Code: | 900772006 |
| Phone Number: | 3104708878 |
| Fax Number: | 3104708878 |
| NPI Enumeration Date: | 09/27/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 171000000X |
| License Number: | GI2306 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Other Service Providers |
| Taxonomy Classification: | Military Health Care Provider |
| Taxonomy Specialization: | |
| Taxonomy Definition: | Active duty military health care providers not otherwise classified who need to be separately identified for operational, clinical, or administrative processes. |