Provider Demographics
NPI:1609890813
Name:FERBER, JEFFREY MARTIN (MD)
Entity Type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:MARTIN
Last Name:FERBER
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 1:1926 VIA CTR
Mailing Address - Street 2:
Mailing Address - City:VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:92081-6056
Mailing Address - Country:US
Mailing Address - Phone:760-940-7000
Mailing Address - Fax:760-940-0042
Practice Address - Street 1:1926 VIA CTR
Practice Address - Street 2:
Practice Address - City:VISTA
Practice Address - State:CA
Practice Address - Zip Code:92081-6056
Practice Address - Country:US
Practice Address - Phone:760-940-7000
Practice Address - Fax:760-940-0042
Is Sole Proprietor?:No
Enumeration Date:2006-07-27
Last Update Date:2019-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG52181207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACB234408OtherMEDICARE
CA00G521810Medicaid
CAA52188Medicare UPIN