Healthcare Provider Details

I. General information

NPI: 1366767535
Provider Name (Legal Business Name): CORINA PEREZ HERNANDEZ NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/31/2010
Last Update Date: 06/07/2023
Certification Date: 06/07/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9090 WILSHIRE BLVD FL 2
BEVERLY HILLS CA
90211-1888
US

IV. Provider business mailing address

4140 W 190TH ST
TORRANCE CA
90504-5513
US

V. Phone/Fax

Practice location:
  • Phone: 310-285-7231
  • Fax: 310-285-7292
Mailing address:
  • Phone: 310-285-7231
  • Fax: 310-285-7292

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number18578
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number18578
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: