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NPI Code Detail

MEDICARE: KEVIN PEREZ

MEDICARE: KEVIN 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
1172V00000XCommunity Health Worker

General Provider Information

NPI Number : 1831953306
Entity Type Code : Individual
Provider Name (Legal Business Name) : KEVIN PEREZ
Provider Business Mailing Address
First Line : 348 E 600 S
Second Line :
City : SAINT GEORGE
State : UT
Zip : 84770-3949
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1789 N WEDGEWOOD LN
Second Line :
City : CEDAR CITY
State : UT
Zip : 84721-7769
Country : US
Telephone Number : 435-705-7574
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/06/2024
Last Update Date : 02/06/2024

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Directions to “ KEVIN PEREZ ” Practice Location

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