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General NPI Number Information
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NPI Number | 1346144797
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Entity Type | Individual
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Provider Name | EVAN PERRY
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Gender |
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Dates
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Enumeration Date | 10/07/2026
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Last Update Date | 10/07/2026
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Provider Practice Location Address
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Address Line | 4900 WILSHIRE BLVD
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City | LOS ANGELES
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State | CA
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Zip | 90010-3805
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Country | US
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Telephone | 323-836-0860
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Fax |
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Provider Business Mailing Address
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Address Line | 1297 W 36TH ST
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City | LOS ANGELES
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State | CA
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Zip | 90007-3935
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Country | US
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Telephone |
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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 | 171400000X
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Taxonomy Name | Health & Wellness Coach
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License Number | B133B9A248
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License Number State | CA
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