Individual
DIANNA P FERGUSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
4323 W RIVERSIDE DR, BURBANK, CA 91505-4044
(818) 556-2700
(818) 563-9459
Mailing address
23388 MULHOLLAND DR, MAILSTOP 62, WOODLAND HILLS, CA 91364-2733
(818) 556-2700
(818) 563-9459
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
G77697
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00G766970
BLUE SHIELD
CA
Enumeration date
09/26/2006
Last updated
11/30/2021
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