Healthcare Provider Details
I. General information
NPI: 1730800939
Provider Name (Legal Business Name): MONICA PERLMAN MD, INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/06/2022
Last Update Date: 09/06/2022
Certification Date: 09/06/2022
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2790 TRUXTUN RD STE 120A
SAN DIEGO CA
92106-6135
US
IV. Provider business mailing address
9850 GENESEE AVE STE 320
LA JOLLA CA
92037-1208
US
V. Phone/Fax
- Phone: 619-222-1253
- Fax: 858-795-1195
- Phone: 858-554-1212
- Fax: 858-795-1195
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208000000X |
| Taxonomy | Pediatrics Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
MONICA
PERLMAN
Title or Position: MEDICAL DIRECTOR
Credential: MD
Phone: 858-554-1212