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General NPI Number Information
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NPI Number | 1851949580
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Entity Type | Individual
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Provider Name | MICHAEL PEREZ
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Gender | Male
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Dates
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Enumeration Date | 08/27/2019
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Last Update Date | 11/14/2025
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Provider Practice Location Address
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Address Line | 2051 MARENGO ST
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City | LOS ANGELES
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State | CA
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Zip | 90033-1352
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Country | US
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Telephone | 323-409-9088
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Fax |
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Provider Business Mailing Address
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Address Line | 1000 S GRAND AVE APT 429
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City | LOS ANGELES
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State | CA
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Zip | 90015-3473
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Country | US
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Telephone | 323-409-4088
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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 | 163WP0807X
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Taxonomy Name | Child & Adolescent Psychiatric/Mental Health Registered Nurse
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License Number | 687903
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | NP95028266
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License Number State | CA
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