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General NPI Number Information
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NPI Number | 1063411858
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Entity Type | Individual
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Provider Name | ANGELA FAYE PERRY M.D.
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Gender | Female
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Dates
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Enumeration Date | 07/14/2005
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Last Update Date | 05/22/2023
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Provider Practice Location Address
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Address Line | 2619 E COLORADO BLVD STE 150
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City | PASADENA
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State | CA
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Zip | 91107-3747
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Country | US
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Telephone | 626-793-4168
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Fax | 626-793-6256
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Provider Business Mailing Address
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Address Line | 14726 RAMONA AVE STE 203
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City | CHINO
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State | CA
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Zip | 91710-5730
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Country | US
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Telephone | 626-305-9100
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Fax | 626-305-0152
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | L5874
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | G71893
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 208200000X
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Taxonomy Name | Plastic Surgery Physician
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License Number | L5874
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License Number State | TX
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Taxonomy #4
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Taxonomy Code | 207WX0200X
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Taxonomy Name | Ophthalmic Plastic and Reconstructive Surgery Physician
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License Number | G71893
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License Number State | CA
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