Provider Demographics
NPI:1639118110
Name:FERRO, THOMAS DANIEL (MD)
Entity type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:DANIEL
Last Name:FERRO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:860 OAK PARK BLVD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:ARROYO GRANDE
Mailing Address - State:CA
Mailing Address - Zip Code:93420-1800
Mailing Address - Country:US
Mailing Address - Phone:805-481-3685
Mailing Address - Fax:805-481-5245
Practice Address - Street 1:860 OAK PARK BLVD
Practice Address - Street 2:SUITE 101
Practice Address - City:ARROYO GRANDE
Practice Address - State:CA
Practice Address - Zip Code:93420-1800
Practice Address - Country:US
Practice Address - Phone:805-481-3685
Practice Address - Fax:805-481-5245
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-06
Last Update Date:2021-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG57590207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G575240Medicaid
CA00G575240Medicaid
CAE85724Medicare UPIN
CAW14440AMedicare ID - Type UnspecifiedMEDICARE GROUP ID