Individual provider Active NPI

Leticia Perez

  • Physician Assistant
  • Los Angeles, CA
National Provider Identifier
1588376040
Registry record updated Aug 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA66828 Issued in CA
Practice address
1005 E Washington Blvd
Los Angeles, CA 90021-3068
Phone
(323) 233-3100
NPI assigned
Dec 15, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 25, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA66828 CA Primary

Addresses

Primary practice location

1005 E Washington Blvd
Los Angeles, CA 90021-3068

Mailing address

1005 E Washington Blvd
Los Angeles, CA 90021-3068

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251014003011 CA Practitioner - Physician Assistant 8022505072 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of Southern California Keck School of Medicine, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2801 S San Pedro St
Los Angeles, CA 90011-2023

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PA66828CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Universal Community Health Center CurrentSince Aug 4, 2025 Accepting new patients
Universal Community Health Center Current Accepting new patients
Universal Community Health Center CurrentSince Aug 4, 2025 Accepting new patients

Locations

1919 S San Pedro St
Los Angeles, CA 90011
Phone (323) 233-3100

1005 E Washington Blvd
Los Angeles, CA 90021
Phone (213) 745-3636

1005 E Washington Blvd
Ste A
Los Angeles, CA 90021
Phone (213) 745-3636

2801 S San Pedro St
Los Angeles, CA 90011
Phone (323) 233-3100

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/DFGBDA

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1671062400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756080000000",
    "number": "1588376040",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1005 E WASHINGTON BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900213068"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1005 E WASHINGTON BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900213068",
            "telephone_number": "323-233-3100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEREZ",
        "first_name": "LETICIA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-12-15",
        "last_updated": "2025-08-25",
        "certification_date": "2025-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA66828",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.