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General NPI Number Information
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NPI Number | 1982913844
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Entity Type | Individual
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Provider Name | SEBASTIEN MARIE GERARD DE FERAUDY MD-PHD
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Gender | Male
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Dates
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Enumeration Date | 09/27/2010
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Last Update Date | 07/25/2025
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Provider Practice Location Address
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Address Line | 2420 SAMARITAN DR
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City | SAN JOSE
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State | CA
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Zip | 95124
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Country | US
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Telephone | 408-369-5600
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Fax | 408-369-5625
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Provider Business Mailing Address
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Address Line | 6 BEACH RD UNIT 229
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City | TIBURON
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State | CA
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Zip | 94920-2802
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Country | US
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Telephone |
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Fax |
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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 | 207ZP0101X
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Taxonomy Name | Anatomic Pathology Physician
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License Number | A118148
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License Number State | CA
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