Provider Demographics
NPI:1447223730
Name:FERRETTI, MICHAEL STEVEN (OD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:STEVEN
Last Name:FERRETTI
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 1:2162 ROBINSON ST
Mailing Address - Street 2:
Mailing Address - City:OROVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95965-4937
Mailing Address - Country:US
Mailing Address - Phone:530-534-8807
Mailing Address - Fax:530-534-8811
Practice Address - Street 1:2162 ROBINSON ST
Practice Address - Street 2:
Practice Address - City:OROVILLE
Practice Address - State:CA
Practice Address - Zip Code:95965-4937
Practice Address - Country:US
Practice Address - Phone:530-534-8807
Practice Address - Fax:530-534-8811
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-08
Last Update Date:2010-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA7455T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA9074714Medicaid
CASD0074550Medicare PIN
CA0216070001Medicare NSC