Healthcare Provider Details

I. General information

NPI: 1942253273
Provider Name (Legal Business Name): PEREZ SURGICAL MEDICAL GROUP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/18/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1510 S CENTRAL AVE #200
GLENDALE CA
91204-2500
US

IV. Provider business mailing address

1510 S CENTRAL AVE #200
GLENDALE CA
91204-2500
US

V. Phone/Fax

Practice location:
  • Phone: 818-500-9973
  • Fax: 818-500-1204
Mailing address:
  • Phone: 818-500-9973
  • Fax: 818-500-1204

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085U0001X
TaxonomyDiagnostic Ultrasound Physician
License NumberN/A
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberN/A
License Number StateCA

VIII. Authorized Official

Name: DR. DARIO PEREZ
Title or Position: PRESIDENT
Credential: M.D.
Phone: 818-500-9973