MEDICARE: JUAN G PEREZ

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	106S00000X	Behavior Technician		CA

General Provider Information

NPI Number	:	1316802721
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JUAN G PEREZ

Provider Business Mailing Address
First Line	:	4904 ELTON ST
Second Line	:
City	:	BALDWIN PARK
State	:	CA
Zip	:	91706-1908
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	9650 TELSTAR AVE STE 103
Second Line	:
City	:	EL MONTE
State	:	CA
Zip	:	91731-3011
Country	:	US
Telephone Number	:	626-592-9886
Fax Number	:

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

Provider Enumeration Date	:	12/18/2025
Last Update Date	:	12/18/2025

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Directions to “ JUAN G PEREZ ” Practice Location

Language	Start Address	Practice Location

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