| Luis Perez, M.d., A Professional Corporation | |
|
716 E Mission Blvd Suite D Pomona CA 91766-2040 | |
| (909) 865-2332 | |
| Not Available |
| Full Name | Luis Perez, M.d., A Professional Corporation |
|---|---|
| Speciality | Family Medicine |
| Location | 716 E Mission Blvd, Pomona, California |
| Authorized Official Name and Position | Luis J Perez (PRESIDENT/M.D.) |
| Authorized Official Contact | 9098652332 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Luis Perez, M.d., A Professional Corporation 716 E Mission Blvd Suite D Pomona CA 91766-2040 Ph: (909) 865-2332 | Luis Perez, M.d., A Professional Corporation 716 E Mission Blvd Suite D Pomona CA 91766-2040 Ph: (909) 865-2332 |
| NPI Number | 1053343509 |
|---|---|
| Provider Enumeration Date | 07/07/2006 |
| Last Update Date | 11/13/2007 |
| Medicare PECOS PAC ID | 7810882453 |
|---|---|
| Medicare Enrollment ID | O20040508000358 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053343509 | NPI | - | NPPES |
| 00G725380 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | G72538 (California) | Primary |
| Provider Name | Luis J Perez |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1225099880 PECOS PAC ID: 1254226897 Enrollment ID: I20040224001143 |
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