Healthcare Provider Details

I. General information

NPI: 1144038027
Provider Name (Legal Business Name): DAVID JOSEPH PEREZ PA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/23/2024
Last Update Date: 07/24/2026
Certification Date: 07/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5315 RENO CORPORATE DR STE 100
RENO NV
89511-2615
US

IV. Provider business mailing address

5315 RENO CORPORATE DR STE 100
RENO NV
89511-2615
US

V. Phone/Fax

Practice location:
  • Phone: 775-359-1660
  • Fax: 775-201-8376
Mailing address:
  • Phone: 775-359-1660
  • Fax: 775-201-8376

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA3179
License Number StateNV
# 2
Primary TaxonomyN
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License NumberPA3179
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: