Healthcare Provider Details

I. General information

NPI: 1396236311
Provider Name (Legal Business Name): ROSIO MIGUEL PEREZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/24/2018
Last Update Date: 05/24/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1123 BALDWIN ST
SALINAS CA
93906-3681
US

IV. Provider business mailing address

482 CRIVELLO RD
MARINA CA
93933-3407
US

V. Phone/Fax

Practice location:
  • Phone: 916-793-1097
  • Fax:
Mailing address:
  • Phone: 657-217-9709
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374700000X
TaxonomyTechnician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: