Provider Demographics
NPI:1932168051
Name:FERRERAS, RICHARD A (MD)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:A
Last Name:FERRERAS
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 1:1100 N INDIAN CYN DR STE 109
Mailing Address - Street 2:
Mailing Address - City:PALM SPRINGS
Mailing Address - State:CA
Mailing Address - Zip Code:92262-4418
Mailing Address - Country:US
Mailing Address - Phone:760-992-7171
Mailing Address - Fax:760-327-3846
Practice Address - Street 1:1100 N INDIAN CYN DR STE 109
Practice Address - Street 2:
Practice Address - City:PALM SPRINGS
Practice Address - State:CA
Practice Address - Zip Code:92262-4418
Practice Address - Country:US
Practice Address - Phone:760-992-7171
Practice Address - Fax:760-327-3846
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-18
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG49019207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAWG49019BMedicare PIN
A51241Medicare UPIN
CAWG49019BMedicare ID - Type Unspecified
CACX692XMedicare PIN