Active NPI
Gonzalo Perez Jr.
- Rehabilitation Practitioner
- Los Angeles, CA
National Provider Identifier
1356475545
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Rehabilitation Practitioner
- Practice address
- 840 N Avenue 66
Los Angeles, CA 90042-1508 - Phone
- (626) 395-7100
- NPI assigned
- Mar 16, 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Case Manager/Care Coordinator | 171M00000X | |||
| Rehabilitation Practitioner | 225400000X | CA | Primary |
Addresses
Primary practice location
840 N Avenue 66
Los Angeles, CA 90042-1508
Mailing address
840 N Avenue 66
Los Angeles, CA 90042-1508
Phone (626) 395-7100
Other practice location 1
3808 Flower St
Cudahy, CA 90201-4108
Phone (323) 773-5836
Other practice location 2
5628 E Slauson Ave
Commerce, CA 90040-2922
Phone (323) 318-9960
Other practice location 3
108 W Victoria St
Gardena, CA 90248-3523
Phone (310) 715-2020
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 95-2633765 | Medicaid | CA |
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": "1174003200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1740009600000",
"number": "1356475545",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "840 N AVENUE 66",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900421508",
"telephone_number": "626-395-7100"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "840 N AVENUE 66",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900421508",
"telephone_number": "626-395-7100"
}
],
"practiceLocations": [
{
"address_1": "3808 Flower St",
"address_purpose": "LOCATION",
"city": "Cudahy",
"state": "CA",
"postal_code": "902014108",
"country_code": "US",
"telephone_number": "323-773-5836",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "5628 E Slauson Ave",
"address_purpose": "LOCATION",
"city": "Commerce",
"state": "CA",
"postal_code": "900402922",
"country_code": "US",
"telephone_number": "323-318-9960",
"fax_number": "323-780-3211",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "108 W Victoria St",
"address_purpose": "LOCATION",
"city": "Gardena",
"state": "CA",
"postal_code": "902483523",
"country_code": "US",
"telephone_number": "310-715-2020",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "PEREZ",
"first_name": "GONZALO",
"name_suffix": "Jr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-03-16",
"last_updated": "2025-02-20",
"certification_date": "2025-02-20",
"status": "A"
},
"taxonomies": [
{
"code": "171M00000X",
"taxonomy_group": "",
"desc": "Case Manager/Care Coordinator",
"state": null,
"license": null,
"primary": false
},
{
"code": "225400000X",
"taxonomy_group": "",
"desc": "Rehabilitation Practitioner",
"state": "CA",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "95-2633765",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 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.