| Annette a Coronel-perey MD Inc | |
|
1045 W Redondo Beach Blvd Suite 100 Gardena CA 90247-4128 | |
| (310) 532-5558 | |
| Not Available |
| Full Name | Annette a Coronel-perey MD Inc |
|---|---|
| Speciality | Pediatrics |
| Location | 1045 W Redondo Beach Blvd, Gardena, California |
| Authorized Official Name and Position | Annette A. Coronel-perey (PEDIATRICIAN) |
| Authorized Official Contact | 3105325558 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Annette a Coronel-perey MD Inc 1045 W Redondo Beach Blvd Suite 100 Gardena CA 90247-4128 Ph: (310) 532-5558 | Annette a Coronel-perey MD Inc 1045 W Redondo Beach Blvd Suite 100 Gardena CA 90247-4128 Ph: (310) 532-5558 |
| NPI Number | 1952670341 |
|---|---|
| Provider Enumeration Date | 12/14/2011 |
| Last Update Date | 10/08/2024 |
| Certification Date | 10/08/2024 |
| Medicare PECOS PAC ID | 9133652696 |
|---|---|
| Medicare Enrollment ID | O20241023001570 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1952670341 | NPI | - | NPPES |
| 00A552530 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (NU) | Secondary |
| 208000000X | Pediatrics | A55253 (California) | Primary |
| Provider Name | Pricilla Louise Perey Generoso |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1053987305 PECOS PAC ID: 8628479557 Enrollment ID: I20241024000934 |
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