Healthcare Provider Details

I. General information

NPI: 1124101084
Provider Name (Legal Business Name): EVELYN PEREZ OD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/23/2006
Last Update Date: 05/14/2026
Certification Date: 05/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

229 E BEVERLY BLVD
MONTEBELLO CA
90640-3776
US

IV. Provider business mailing address

14726 RAMONA AVE STE 203
CHINO CA
91710-5730
US

V. Phone/Fax

Practice location:
  • Phone: 562-354-9522
  • Fax:
Mailing address:
  • Phone: 626-305-9100
  • Fax: 626-305-0152

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberOPT10155T
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: