Active NPI
Gary Lynn Perrault, MD
- Surgery Physician
- Beverly Hills, CA
National Provider Identifier
1295956175
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- G79686
- Practice address
- 414 North Camden Dr.
Suite 725
Beverly Hills, CA 90210 - Phone
- (310) 281-2121
- Fax
- (310) 281-2150
- NPI assigned
- May 1, 2007
- 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 |
|---|---|---|---|---|
| Surgery Physician | 208600000X | G79686 | CA | Primary |
Addresses
Primary practice location
414 North Camden Dr.
Suite 725
Beverly Hills, CA 90210
Mailing address
414 North Camden Dr.
Suite 725
Beverly Hills, CA 90210
Phone (310) 281-2121
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20140725000614 | CA | Order and Referring Only - General Surgery | 1557587623 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 79686 | CA | MD | Pharmacist |
| G79686 | CA | MD | Surgery Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1177977600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1228262400000",
"number": "1295956175",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "414 NORTH CAMDEN DR.",
"address_2": "SUITE 725",
"city": "BEVERLY HILLS",
"state": "CA",
"postal_code": "90210",
"telephone_number": "310-281-2121",
"fax_number": "310-281-2150"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "414 NORTH CAMDEN DR.",
"address_2": "SUITE 725",
"city": "BEVERLY HILLS",
"state": "CA",
"postal_code": "90210",
"telephone_number": "310-281-2121",
"fax_number": "310-281-2150"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PERRAULT",
"first_name": "GARY",
"middle_name": "LYNN",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-05-01",
"last_updated": "2008-12-03",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "CA",
"license": "G79686",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Beverly Hills, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.