Provider Demographics
NPI:1265688162
Name:FERRIS, TODD A (MD, MS)
Entity Type:Individual
Prefix:DR
First Name:TODD
Middle Name:A
Last Name:FERRIS
Suffix:
Gender:M
Credentials:MD, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:3172 PORTER DR
Mailing Address - Street 2:
Mailing Address - City:PALO ALTO
Mailing Address - State:CA
Mailing Address - Zip Code:94304-1212
Mailing Address - Country:US
Mailing Address - Phone:650-725-1825
Mailing Address - Fax:650-725-4415
Practice Address - Street 1:3172 PORTER DR
Practice Address - Street 2:
Practice Address - City:PALO ALTO
Practice Address - State:CA
Practice Address - Zip Code:94304-1212
Practice Address - Country:US
Practice Address - Phone:650-725-1825
Practice Address - Fax:650-725-4415
Is Sole Proprietor?:No
Enumeration Date:2008-08-11
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA70409207Q00000X, 2083C0008X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083C0008XAllopathic & Osteopathic PhysiciansPreventive MedicineClinical Informatics
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAH71573Medicare UPIN