MEDICARE: DR. RODNEY PERKINS M.D.

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	207YX0901X	Otology & Neurotology Physician	C24414	CA

General Provider Information

NPI Number	:	1700284023
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RODNEY PERKINS M.D.

Provider Business Mailing Address
First Line	:	2995 WOODSIDE RD
Second Line	:	SUITE 100
City	:	WOODSIDE
State	:	CA
Zip	:	94062-2443
Country	:	US
Telephone Number	:	650-323-0300
Fax Number	:	650-529-0220

Provider Business Practice Location Address
First Line	:	2995 WOODSIDE RD
Second Line	:	SUITE 100
City	:	WOODSIDE
State	:	CA
Zip	:	94062-2443
Country	:	US
Telephone Number	:	650-323-0300
Fax Number	:	650-529-0220

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

Provider Enumeration Date	:	12/18/2014
Last Update Date	:	12/18/2014

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