Healthcare Provider Details

I. General information

NPI: 1194758680
Provider Name (Legal Business Name): STEVEN P PERRIN MIDWIFE
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

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

III. Provider practice location address

200 W ARBOR DR
SAN DIEGO CA
92103-9001
US

IV. Provider business mailing address

2545 FRONT ST
SAN DIEGO CA
92103-6516
US

V. Phone/Fax

Practice location:
  • Phone: 619-563-0250
  • Fax: 619-543-3183
Mailing address:
  • Phone: 619-544-1213
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License NumberNMW375
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: