MEDICARE: PERLA MARQUEZ OD

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	152W00000X	Optometrist	35834	CA

General Provider Information

NPI Number	:	1972336337
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PERLA MARQUEZ OD

Provider Business Mailing Address
First Line	:	6001 PACIFIC BLVD
Second Line	:
City	:	HUNTINGTON PARK
State	:	CA
Zip	:	90255-2947
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	6001 PACIFIC BLVD
Second Line	:
City	:	HUNTINGTON PARK
State	:	CA
Zip	:	90255-2947
Country	:	US
Telephone Number	:	323-923-9000
Fax Number	:

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

Provider Enumeration Date	:	08/21/2024
Last Update Date	:	04/17/2026

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