Individual
CORY FERGUSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
57402 29 PALMS HWY, STE 5, YUCCA VALLEY, CA 92284-2950
(760) 365-2520
(760) 365-2524
Mailing address
57402 29 PALMS HWY, STE 5, YUCCA VALLEY, CA 92284-2950
(760) 365-2520
(760) 365-2524
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA22750
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PA22750
PA LICENSE
CA
Enumeration date
01/30/2013
Last updated
03/07/2023
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