MEDICARE: VERONICA 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	171M00000X	Case Manager/Care Coordinator	B9420286	CA

General Provider Information

NPI Number	:	1588877740
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VERONICA PEREZ

Provider Business Mailing Address
First Line	:	1242 ILEXEY AVE
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92154-3716
Country	:	US
Telephone Number	:	619-925-6024
Fax Number	:

Provider Business Practice Location Address
First Line	:	1124 BAY BLVD. SUITE D
Second Line	:
City	:	CHULA VISTA
State	:	CA
Zip	:	91911-3723
Country	:	US
Telephone Number	:	619-420-3620
Fax Number	:	619-420-8722

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

Provider Enumeration Date	:	05/07/2007
Last Update Date	:	01/23/2008

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Directions to “ VERONICA PEREZ ” Practice Location

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