Healthcare Provider Details

I. General information

NPI: 1396111696
Provider Name (Legal Business Name): LIAT PERL M.D
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/20/2015
Last Update Date: 08/20/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

550 16TH ST 4TH FL
SAN FRANCISCO CA
94158-2549
US

IV. Provider business mailing address

27644 NATOMA RD
LOS ALTOS HILLS CA
94022-3215
US

V. Phone/Fax

Practice location:
  • Phone: 415-476-2981
  • Fax:
Mailing address:
  • Phone: 650-422-8188
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0205X
TaxonomyPediatric Endocrinology Physician
License Number2005537
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: