Active NPI
Jose Norberto Perez Jr., PHYSICIAN ASSISTANT
- Physician Assistant
- San Mateo, CA
National Provider Identifier
1336294651
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA17928
- Practice address
- 100 S San Mateo Dr
San Mateo, CA 94401-3805 - Phone
- (650) 696-5034
- NPI assigned
- Jan 25, 2007
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA17928 | CA | Primary |
Addresses
Primary practice location
100 S San Mateo Dr
San Mateo, CA 94401-3805
Mailing address
325 Distel Cir
Los Altos, CA 94022-1408
Phone (650) 696-5034
Other practice location 1
24 Valley St
San Francisco, CA 94110-4922
Phone (415) 641-6667
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)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 17928 | CA | MD | Acupuncturist |
Interoperability endpoints
- jperez49101@hisp.ehr.sutterhealth.org
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1169683200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1592870400000",
"number": "1336294651",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "325 DISTEL CIR",
"city": "LOS ALTOS",
"state": "CA",
"postal_code": "940221408",
"telephone_number": "650-696-5034",
"fax_number": "415-641-6802"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 S SAN MATEO DR",
"city": "SAN MATEO",
"state": "CA",
"postal_code": "944013805",
"telephone_number": "650-696-5034"
}
],
"practiceLocations": [
{
"address_1": "24 Valley St",
"address_purpose": "LOCATION",
"city": "San Francisco",
"state": "CA",
"postal_code": "941104922",
"country_code": "US",
"telephone_number": "415-641-6667",
"fax_number": "415-641-6802",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "PEREZ",
"first_name": "JOSE",
"middle_name": "NORBERTO",
"name_prefix": "Mr.",
"name_suffix": "Jr.",
"credential": "PHYSICIAN ASSISTANT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-01-25",
"last_updated": "2020-06-23",
"certification_date": "2020-06-23",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "CA",
"license": "PA17928",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Mateo, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 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.