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General NPI Number Information
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NPI Number | 1073826657
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Entity Type | Individual
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Provider Name | BERNARDO PEREZ III D.C.
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Gender | Male
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Dates
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Enumeration Date | 07/23/2010
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Last Update Date | 07/27/2010
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Provider Practice Location Address
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Address Line | 74 N FAIR OAKS AVE
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City | PASADENA
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State | CA
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Zip | 91103-3610
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Country | US
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Telephone | 626-344-8382
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Fax |
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Provider Business Mailing Address
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Address Line | 618 FAIRVIEW AVE #116
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City | ARCADIA
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State | CA
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Zip | 91007-6781
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Country | US
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Telephone | 626-826-2182
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Fax |
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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 | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 31709
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License Number State | CA
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