Active NPI
Eduardo Perez
- Community Health Worker
- Upland, CA
National Provider Identifier
1225904667
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community Health Worker
- Practice address
- 1933 W 11TH St Ste I
Upland, CA 91786-3562 - Phone
- (951) 682-0088
- Fax
- (888) 909-4209
- NPI assigned
- Oct 14, 2025
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community Health Worker | 172V00000X | Primary |
Addresses
Primary practice location
1933 W 11TH St Ste I
Upland, CA 91786-3562
Mailing address
1933 W 11TH St Ste I
Upland, CA 91786-3562
Phone (951) 682-0088
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1760400000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1760400000000",
"number": "1225904667",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1933 W 11TH ST STE I",
"city": "UPLAND",
"state": "CA",
"postal_code": "917863562",
"telephone_number": "951-682-0088",
"fax_number": "888-909-4209"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1933 W 11TH ST STE I",
"city": "UPLAND",
"state": "CA",
"postal_code": "917863562",
"telephone_number": "951-682-0088",
"fax_number": "888-909-4209"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PEREZ",
"first_name": "EDUARDO",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2025-10-14",
"last_updated": "2025-10-14",
"certification_date": "2025-10-14",
"status": "A"
},
"taxonomies": [
{
"code": "172V00000X",
"taxonomy_group": "",
"desc": "Community Health Worker",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Upland, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.