Individual
KEVIN L FERGUSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1400 E CHURCH ST, SANTA MARIA, CA 93454-5906
(805) 548-1550
Mailing address
PO BOX 8139, SAN LUIS OBISPO, CA 93403-8139
(805) 541-6033
(805) 549-7463
Taxonomy
Speciality
Code
Description
License number
State
207ZH0000X
Hematology (Pathology) Physician
A71757
CA
207ZP0105X
Clinical Pathology/Laboratory Medicine Physician
Primary
A71757
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A717570
—
CA
05
—
GR0058760
—
CA
05
—
LAB43503F
—
CA
Enumeration date
06/26/2006
Last updated
09/07/2023
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