Healthcare Provider Details

I. General information

NPI: 1255474375
Provider Name (Legal Business Name): PERCY NARANJO M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/15/2007
Last Update Date: 09/09/2020
Certification Date: 09/09/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7516 PACIFIC BLVD STE 206
WALNUT PARK CA
90255-6052
US

IV. Provider business mailing address

2677 ZOE AVE STE 120
HUNTINGTON PARK CA
90255-6995
US

V. Phone/Fax

Practice location:
  • Phone: 323-786-1238
  • Fax:
Mailing address:
  • Phone: 323-638-1038
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberA35198
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: