MEDICARE: GLORIA PEREZ CRAIG NP

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	363L00000X	Nurse Practitioner	NP19875	CA
2	363LA2200X	Adult Health Nurse Practitioner	375381	CA
3	363LG0600X	Gerontology Nurse Practitioner	375381	CA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	P01376455	OTHER	CA	RR MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1659681096
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GLORIA PEREZ CRAIG NP

Provider Business Mailing Address
First Line	:	PO BOX 35380
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89133-5380
Country	:	US
Telephone Number	:	702-579-3203
Fax Number	:

Provider Business Practice Location Address
First Line	:	2600 REDONDO AVE
Second Line	:
City	:	LONG BEACH
State	:	CA
Zip	:	90806-2325
Country	:	US
Telephone Number	:	562-988-7000
Fax Number	:

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

Provider Enumeration Date	:	10/19/2010
Last Update Date	:	12/10/2025

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