MEDICARE: GUILLERMO PEREZ

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	390200000X	Student in an Organized Health Care Education/Training Program

General Provider Information

NPI Number	:	1043176373
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GUILLERMO PEREZ

Provider Business Mailing Address
First Line	:	44950 VISTA DUNES LN APT 8
Second Line	:
City	:	LA QUINTA
State	:	CA
Zip	:	92253-4196
Country	:	US
Telephone Number	:	442-933-1196
Fax Number	:

Provider Business Practice Location Address
First Line	:	43500 MONTEREY AVE
Second Line	:
City	:	PALM DESERT
State	:	CA
Zip	:	92260-9399
Country	:	US
Telephone Number	:	760-346-8041
Fax Number	:

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

Provider Enumeration Date	:	12/30/2025
Last Update Date	:	12/30/2025

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Directions to “ GUILLERMO PEREZ ” Practice Location

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