Healthcare Provider Details

I. General information

NPI: 1982545711
Provider Name (Legal Business Name): HAVIER AMIR PEREZ
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/04/2026
Last Update Date: 04/04/2026
Certification Date: 04/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25425 JEFFERSON AVE STE 105
MURRIETA CA
92562-9801
US

IV. Provider business mailing address

31794 MONIQUE CIR
TEMECULA CA
92591-6920
US

V. Phone/Fax

Practice location:
  • Phone: 619-416-1184
  • Fax:
Mailing address:
  • Phone: 619-416-1184
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number100464
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: