MEDICARE: STEVEN PEREZ D.O.

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	207QG0300X	Geriatric Medicine (Family Medicine) Physician	R2291	AZ
2	207Q00000X	Family Medicine Physician	R2291	AZ

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	Z203821	OTHER	AZ	MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	R2291	OTHER	AZ	TRAINING PERMIT

General Provider Information

NPI Number	:	1730528688
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STEVEN PEREZ D.O.

Provider Business Mailing Address
First Line	:	4801 E WASHINGTON ST STE 200
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85034-2019
Country	:	US
Telephone Number	:	602-797-7099
Fax Number	:

Provider Business Practice Location Address
First Line	:	555 N 18TH ST STE 300
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85006-3759
Country	:	US
Telephone Number	:	602-507-4457
Fax Number	:	602-507-4459

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

Provider Enumeration Date	:	06/24/2013
Last Update Date	:	09/11/2019

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Directions to “ STEVEN PEREZ D.O.” Practice Location

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