Justin Perez, M.D.

Primary specialty

Plastic Surgery PhysicianTaxonomy code 208200000X

License

A167469 Issued in CA

Practice address

4560 Admiralty Way
Marina del Rey, CA 90292-5423

Phone

(813) 446-4867

NPI assigned

Apr 21, 2014

Last updated

Sep 25, 2020By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1398038400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600992000000",
    "number": "1114347986",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13603 MARINA POINTE DR APT A518",
            "city": "MARINA DEL REY",
            "state": "CA",
            "postal_code": "902925588",
            "telephone_number": "813-446-4867"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4560 ADMIRALTY WAY",
            "city": "MARINA DEL REY",
            "state": "CA",
            "postal_code": "902925423",
            "telephone_number": "813-446-4867"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "420 E 70th St",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100215320",
            "country_code": "US",
            "telephone_number": "813-446-4867",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PEREZ",
        "first_name": "JUSTIN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-04-21",
        "last_updated": "2020-09-25",
        "certification_date": "2020-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "CA",
            "license": "A167469",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ignez Jansen Penna, M.D.
• Lisa Anne Penny, M.A.
• Marvin Peredo
• Adriana Perez
• Christian Perez
• Stephanie Imelda Perez, OTD, OTR/L
• Kelsha Perine
• Colleen Perry, MFT
• Holly Peters
• Petrel Emergency Physicians, a Medical Corporation

• Plastic Surgery Physician in Marina del Rey, CA
• Providers in Marina del Rey, CA by specialty
• Plastic Surgery Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.