Healthcare Provider Details
I. General information
NPI: 1053441287
Provider Name (Legal Business Name): LILIAM PEREZ M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 03/06/2007
Last Update Date: 02/10/2011
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1270 NATIVIDAD RD RM 200
SALINAS CA
93906-3122
US
IV. Provider business mailing address
201 GLENWOOD CIR APT 27D
MONTEREY CA
93940-6707
US
V. Phone/Fax
- Phone: 831-755-4510
- Fax:
- Phone: 646-552-6192
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2084P0800X |
| Taxonomy | Psychiatry Physician |
| License Number | A87095 |
| License Number State | CA |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2084P0805X |
| Taxonomy | Geriatric Psychiatry Physician |
| License Number | A87095 |
| License Number State | CA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: