NPIMap

Individual provider Active NPI

Jose L Perez, M.D.

  • General Practice Physician
  • Los Angeles, CA
National Provider Identifier
1336290691
Registry record updated Nov 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
A74744 Issued in CA
Practice address
4425 S Central Ave
Los Angeles, CA 90011-3629
Phone
(323) 908-4200
NPI assigned
Jan 15, 2007
Last updated
Nov 26, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 26, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X A74744 CA Primary

Addresses

Primary practice location

4425 S Central Ave
Los Angeles, CA 90011-3629

Mailing address

4425 S Central Ave
Los Angeles, CA 90011-3629
Phone (323) 908-4200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041025001148 CA Practitioner - Family Practice 2466413190 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
74744CAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Beverly Community Clinic CurrentSince Nov 17, 2025 Accepting new patients
South Central Family Health Center CurrentSince Oct 1, 2024 Accepting new patients
South Central Family Health Center Current Accepting new patients
Tri-State Community Healthcare Center PastSince May 3, 2017 Accepting new patients
White Memorial Medical Center Past Accepting new patients
Tri-State Community Healthcare Center Past Accepting new patients
Anaheim Global Medical Center, Inc Past Accepting new patients
St Nicholas Medical Group PastSince Nov 17, 2025 Accepting new patients

Locations

7300 Santa Fe Ave
Huntington Pk, CA 90255
Phone (323) 277-8900

2252 Beverly Blvd
Ste 103
Los Angeles, CA 90057
Phone (213) 574-7424

3410 Hooper Ave
Los Angeles, CA 90011

4425 S Central Ave
Los Angeles, CA 90011

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/FDIHCA
  • Direct secure messaging: jose.perez.p1@direct.scfhc.nextgenshare.com

Ownership & related parties

All facility ownership & control disclosures 6

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Huntington Park Family Health CenterHuntington Park, CA, CCN 551073 Federally qualified health center Corporate Officer Mar 16, 2017
South Central Family Health Center-VernonLos Angeles, CA, CCN 921013 Federally qualified health center Corporate Officer Mar 16, 2017
Cudahy Family Health CenterCudahy, CA, CCN 921079 Federally qualified health center Corporate Officer Mar 16, 2017
Montebello Family Health CenterMontebello, CA, CCN 921964 Federally qualified health center Corporate Officer Mar 16, 2017
Wellness Center at Jefferson High SchoolLos Angeles, CA, CCN 921983 Federally qualified health center Corporate Officer Mar 16, 2017
Scfhc - Santa FeHuntington Park, CA, CCN A01004 Federally qualified health center Corporate Officer Mar 16, 2017

Owned or controlled facilities with NPI records 6

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1168819200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732579200000",
    "number": "1336290691",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4425 S CENTRAL AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900113629",
            "telephone_number": "323-908-4200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4425 S CENTRAL AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900113629",
            "telephone_number": "323-908-4200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEREZ",
        "first_name": "JOSE",
        "middle_name": "L",
        "name_prefix": "Mr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-15",
        "last_updated": "2024-11-26",
        "certification_date": "2024-11-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "CA",
            "license": "A74744",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.