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NPI Code Detail

MEDICARE: DR. MICHAEL FARGUSSON M.D

MEDICARE: DR. MICHAEL FARGUSSON M.D
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207P00000XEmergency Medicine PhysicianA138769CA
2390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1053730168
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MICHAEL FARGUSSON M.D
Provider Business Mailing Address
First Line : 195 PAGE MILL RD STE 103
Second Line :
City : PALO ALTO
State : CA
Zip : 94306-2073
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 195 PAGE MILL RD STE 103
Second Line :
City : PALO ALTO
State : CA
Zip : 94306-2073
Country : US
Telephone Number : 888-731-8994
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/16/2014
Last Update Date : 01/09/2026

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