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General NPI Number Information
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NPI Number | 1669982708
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Entity Type | Individual
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Provider Name | STEVEN ALLEN PERINOVIC PA-C
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Gender | Male
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Dates
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Enumeration Date | 10/03/2017
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Last Update Date | 04/30/2021
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Provider Practice Location Address
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Address Line | 1535 RIVER PARK DR STE 200
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City | SACRAMENTO
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State | CA
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Zip | 95815-4601
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Country | US
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Telephone | 916-286-1081
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Fax |
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Provider Business Mailing Address
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Address Line | 1535 RIVER PARK DR
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City | SACRAMENTO
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State | CA
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Zip | 95815-4601
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Country | US
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Telephone | 916-286-1080
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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 | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 54972
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License Number State | CA
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