Provider Demographics
NPI:1346321320
Name:FERRO, DONALD (OD)
Entity Type:Individual
Prefix:
First Name:DONALD
Middle Name:
Last Name:FERRO
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2200 COLORADO AVE.
Mailing Address - Street 2:SUITE E
Mailing Address - City:SANTA MONICA
Mailing Address - State:CA
Mailing Address - Zip Code:90404-3589
Mailing Address - Country:US
Mailing Address - Phone:310-828-6232
Mailing Address - Fax:310-828-5352
Practice Address - Street 1:2200 COLORADO AVE.
Practice Address - Street 2:SUITE E
Practice Address - City:SANTA MONICA
Practice Address - State:CA
Practice Address - Zip Code:90404-3589
Practice Address - Country:US
Practice Address - Phone:310-828-6232
Practice Address - Fax:310-828-5352
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-18
Last Update Date:2008-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAOP 8226T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
U55504Medicare UPIN
CA1303000001Medicare NSC
CAOP8226Medicare ID - Type Unspecified