Healthcare Provider Details

I. General information

NPI: 1366569121
Provider Name (Legal Business Name): CURTIS JOHN PERRY M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/24/2007
Last Update Date: 03/19/2020
Certification Date: 03/19/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15141 WHITTIER BLVD STE 205
WHITTIER CA
90603-2170
US

IV. Provider business mailing address

15141 WHITTIER BLVD STE 205
WHITTIER CA
90603-2170
US

V. Phone/Fax

Practice location:
  • Phone: 562-315-5700
  • Fax: 800-390-5344
Mailing address:
  • Phone: 562-315-5700
  • Fax: 800-390-5344

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2082S0099X
TaxonomyPlastic Surgery Within the Head and Neck (Plastic Surgery) Physician
License NumberRI07729
License Number StateRI
# 2
Primary TaxonomyY
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License NumberG88980
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: