Individual
DR. IAN GLEN FERGUSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
300 PASTEUR DR, STANFORD, CA 94305-2200
(650) 723-4000
Mailing address
1804 EMBARCADERO RD, STE 100, PALO ALTO, CA 94303-3341
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
20A6890
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00AX68900
—
CA
Enumeration date
04/10/2006
Last updated
06/08/2016
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