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James Homer Ferguson

Family Medicine

Allopathic & Osteopathic Physicians

2501 Harbor Blvd, Costa Mesa, CA 92626-6143

PECOS Enrollment

This provider is enrolled in PECOS as JAMES FERGUSON.

Based on the most recent information from CMS, provider James Homer Ferguson is legally eligible to order and refer claims for DME and PMD services only.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records 2 days ago.

Profile Details

Provider ID
1689625212
Provider Type
Individual
Full Name
Ferguson, James Homer
Title
Dr.

Credential
DO
Gender
Male
Enumeration Date
5/16/2006
Last Updated
3/7/2023

Contact Information

Practice Location

2501 Harbor Blvd, Costa Mesa, CA 92626-6143

(714) 957-5000

Unlisted Fax

Mailing Location

1600 9th Street, Room 205 Mailstop 2-3, Sacramento, CA 95814-6414

(916) 654-2431

(916) 654-3186

Provider Taxonomies

Code	Description	License
Code 207Q00000X Primary	Description Family Medicine Allopathic & Osteopathic Physicians	License 20A7415 California

Provider Identifiers

ID	Description	Issuer
ID 020A74150	Description Other	Issuer PIN

James Homer Ferguson

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Provider Identifiers

ID

Description

Issuer

ID

Description

Issuer

Gottschalk, Guy H

Wass, Adam M

Bangsil, Ronald Yusi

Lo-Gomez, Wingshan

Do, Hau

Nguyen, Gina-Nga T

Senaati, Shayan

Nguyen, An Thi-Ngoc

Kao, Michael

Md24 La, Inc.