Provider Demographics
NPI:1508103227
Name:FEREN, ALAN PHILLIP (MD)
Entity Type:Individual
Prefix:DR
First Name:ALAN
Middle Name:PHILLIP
Last Name:FEREN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:326 SHEFFIELD AVE
Mailing Address - Street 2:
Mailing Address - City:MILL VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:94941-3860
Mailing Address - Country:US
Mailing Address - Phone:415-388-3131
Mailing Address - Fax:415-388-3131
Practice Address - Street 1:326 SHEFFIELD AVE
Practice Address - Street 2:
Practice Address - City:MILL VALLEY
Practice Address - State:CA
Practice Address - Zip Code:94941-3860
Practice Address - Country:US
Practice Address - Phone:415-388-3131
Practice Address - Fax:415-388-3131
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-15
Last Update Date:2013-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG24920174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist