Healthcare Provider Details

I. General information

NPI: 1508889007
Provider Name (Legal Business Name): MRS. MACCAIA D. PERKINS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/25/2006
Last Update Date: 05/23/2023
Certification Date: 05/23/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8995 APOLLO WAY
DOWNEY CA
90242-4031
US

IV. Provider business mailing address

FILE # 55745
LOS ANGELES CA
90074-0001
US

V. Phone/Fax

Practice location:
  • Phone: 562-804-3119
  • Fax: 562-804-1882
Mailing address:
  • Phone: 323-549-0567
  • Fax: 323-549-0577

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License NumberHA 4186
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: