MEDICARE: DR. PATRICIA L FERRARO D.P.M.

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
1	213E00000X	Podiatrist	9201	NV
2	213E00000X	Podiatrist	E3664	CA

General Provider Information

NPI Number	:	1356301675
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PATRICIA L FERRARO D.P.M.

Provider Business Mailing Address
First Line	:	2229 BARTON AVE
Second Line	:
City	:	SOUTH LAKE TAHOE
State	:	CA
Zip	:	96150-3411
Country	:	US
Telephone Number	:	530-541-2665
Fax Number	:	530-541-2615

Provider Business Practice Location Address
First Line	:	2229 BARTON AVE
Second Line	:
City	:	SOUTH LAKE TAHOE
State	:	CA
Zip	:	96150-3411
Country	:	US
Telephone Number	:	530-541-2665
Fax Number	:	530-541-2615

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/23/2006
Last Update Date	:	02/04/2021

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