MEDICARE: DR. MARK A PEREA MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	37293	CO

General Provider Information

NPI Number	:	1225092414
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARK A PEREA MD

Provider Business Mailing Address
First Line	:	PO BOX 35380
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89133-5380
Country	:	US
Telephone Number	:	719-463-5600
Fax Number	:

Provider Business Practice Location Address
First Line	:	9695 S YOSEMITE ST
Second Line	:	STE 324
City	:	LONE TREE
State	:	CO
Zip	:	80124-2888
Country	:	US
Telephone Number	:	303-706-9054
Fax Number	:	303-302-9799

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/14/2006
Last Update Date	:	03/20/2025

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