Healthcare Provider Details

I. General information

NPI: 1902810948
Provider Name (Legal Business Name): JOANNE LORENE PERRON M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/27/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2 UPPER RAGSDALE DR STE B110
MONTEREY CA
93940-5736
US

IV. Provider business mailing address

PO BOX 2121
MONTEREY CA
93942-2121
US

V. Phone/Fax

Practice location:
  • Phone: 831-647-3190
  • Fax: 831-373-1007
Mailing address:
  • Phone: 831-647-3190
  • Fax: 831-373-1007

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License NumberG63474
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: