MEDICARE: DEREK PEREZ INDUSTRIES LLC

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	103K00000X	Behavior Analyst

General Provider Information

NPI Number	:	1861375081
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DEREK PEREZ INDUSTRIES LLC

Provider Business Mailing Address
First Line	:	9650 TELSTAR AVENUE UNIT A
Second Line	:	#103
City	:	EL MONTE
State	:	CA
Zip	:	91731-3011
Country	:	US
Telephone Number	:	626-234-4778
Fax Number	:

Provider Business Practice Location Address
First Line	:	11143 BRYANT RD APT 7
Second Line	:
City	:	EL MONTE
State	:	CA
Zip	:	91731-2035
Country	:	US
Telephone Number	:	626-234-4778
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	MR. DEREK PEREZ
Credential	:
Telephone Number	:	626-234-4778

Provider Enumeration Date	:	07/26/2025
Last Update Date	:	10/21/2025

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