Individual
FERRY FERDIANTO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1500 OWENS ST, SAN FRANCISCO, CA 94158-2334
(415) 885-3668
Mailing address
1500 OWENS ST, SAN FRANCISCO, CA 94158-2334
(415) 885-3668
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA55394
CA
363AM0700X
Medical Physician Assistant
017304
NY
Other
Enumeration date
03/11/2014
Last updated
08/02/2023
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