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General NPI Number Information
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NPI Number | 1245258359
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Entity Type | Individual
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Provider Name | STEVEN PAUL FERDIG MPT, OCS
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Gender | Male
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Dates
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Enumeration Date | 07/17/2006
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Last Update Date | 07/03/2018
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Provider Practice Location Address
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Address Line | 250 EL CAMINO REAL SUITE 100
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City | TUSTIN
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State | CA
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Zip | 92780-3655
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Country | US
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Telephone | 714-838-6999
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Fax | 714-838-7099
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Provider Business Mailing Address
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Address Line | 32 CAMPUS DR SKAGGS BLDG#129
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City | MISSOULA
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State | MT
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Zip | 59812-0001
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Country | US
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Telephone | 406-243-4006
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Fax | 406-243-4303
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT19617
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License Number State | CA
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