Organization Active NPI

Luis a Perez MD Inc

  • General Practice Physician
  • Glendale, CA
National Provider Identifier
1184934648
Registry record updated Oct 18, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
A56266 Issued in CA
Legal business name
LUIS A PEREZ MD INC
Practice address
1220 S Central Ave Ste 102
Glendale, CA 91204-3805
Phone
(818) 396-0074
Fax
(818) 396-0075
NPI assigned
Oct 18, 2010
Last updated
Oct 18, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2010

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

Authorized official

Name
Dr. Luis A Perez, MD
Title
President/Ceo
Phone
(818) 396-0074

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208D00000X A56266 CA Primary

Addresses

Primary practice location

1220 S Central Ave Ste 102
Glendale, CA 91204-3805

Mailing address

1220 S Central Ave Ste 102
Glendale, CA 91204-3805
Phone (818) 396-0074

National Provider Directory

National Provider Directory

Locations

1220 S Central Ave
Ste 102
Glendale, CA 91204
Phone (818) 241-2221

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1287360000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1287360000000",
    "number": "1184934648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1220 S CENTRAL AVE STE 102",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912043805",
            "telephone_number": "818-396-0074",
            "fax_number": "818-396-0075"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1220 S CENTRAL AVE STE 102",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912043805",
            "telephone_number": "818-396-0074",
            "fax_number": "818-396-0075"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LUIS A PEREZ MD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-10-18",
        "last_updated": "2010-10-18",
        "status": "A",
        "authorized_official_last_name": "PEREZ",
        "authorized_official_first_name": "LUIS",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "818-396-0074",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": "CA",
            "license": "A56266",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2010; 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.