Healthcare Provider Details

I. General information

NPI: 1427688894
Provider Name (Legal Business Name): NADIA K. PEREZ L
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/24/2020
Last Update Date: 01/24/2020
Certification Date: 01/24/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CALLE 7MA #8074, ZONA CENTRO ZONA CENTRO
MEXICALI CA
21100
US

IV. Provider business mailing address

P.O. BOX 9008
CALEXICO CA
92232
US

V. Phone/Fax

Practice location:
  • Phone: 760-886-8558
  • Fax: 858-430-3143
Mailing address:
  • Phone: 760-886-8558
  • Fax: 858-430-3143

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State

VIII. Authorized Official

Name: DR. NADIA KARINA PEREZ L
Title or Position: OWNER
Credential: DDS
Phone: 760-886-8558