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General NPI Number Information
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NPI Number | 1295940054
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Entity Type | Organization
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Legal Business Name | ANGEL G PEREZ
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Dates
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Enumeration Date | 05/14/2007
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Last Update Date | 06/18/2008
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Provider Practice Location Address
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Address Line | 1721 N WILMINGTON BLVD
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City | WILMINGTON
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State | CA
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Zip | 90744-1261
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Country | US
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Telephone | 310-835-1414
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Fax | 310-835-4050
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Provider Business Mailing Address
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Address Line | 1721 N WILMINGTON BLVD
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City | WILMINGTON
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State | CA
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Zip | 90744-1261
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Country | US
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Telephone | 310-835-1414
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Fax | 310-835-4050
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Authorized Official
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Title or Position | OWNER
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Name | DR. ANGEL G PEREZ
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Credential | MD
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Telephone | 310-835-1414
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | G79348
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License Number State | CA
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