Healthcare Provider Details

I. General information

NPI: 1073857413
Provider Name (Legal Business Name): PERLOW MEDICAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/26/2012
Last Update Date: 09/07/2022
Certification Date: 09/07/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18321 VENTURA BLVD STE 580
TARZANA CA
91356-6435
US

IV. Provider business mailing address

18321 VENTURA BLVD STE 580
TARZANA CA
91356-6435
US

V. Phone/Fax

Practice location:
  • Phone: 818-344-8822
  • Fax: 818-975-1118
Mailing address:
  • Phone: 818-344-8822
  • Fax: 818-975-1118

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License NumberA21097
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code207VX0000X
TaxonomyObstetrics Physician
License Number20A6634
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number20A6634
License Number StateCA

VIII. Authorized Official

Name: DR. REBECCA LEE PERLOW
Title or Position: PRESIDENT
Credential: D.O.
Phone: 818-344-8822