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Individual

DAVID FERRAZARES

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
3451 E 12TH ST, OAKLAND, CA 94601-3463
(510) 535-3600
(510) 535-4247
Mailing address
1601 FRUITVALE AVE, OAKLAND, CA 94601-2418
(510) 535-4000
(510) 535-4128

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
A60620
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
55-1975
FQHC MEDICARE PART A
CA
05
FHC71021F
CA
01
HAP71021F
FPACT
CA
01
ZZZ29799Z
FQHC MEDICARE PART B
CA
Enumeration date
09/12/2006
Last updated
12/27/2021
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