Individual provider Active NPI

Michael Rae Perez

  • Religious Nonmedical Practitioner
  • Ontario, CA
National Provider Identifier
1598457780
Registry record updated May 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Religious Nonmedical PractitionerTaxonomy code 374K00000X
Practice address
350 S Milliken Ave Ste L
Ontario, CA 91761-7846
Phone
(909) 916-0593
NPI assigned
May 24, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 24, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Religious Nonmedical Practitioner 374K00000X CA Primary

Addresses

Primary practice location

350 S Milliken Ave Ste L
Ontario, CA 91761-7846

Mailing address

6288 Golden Trails Ave
Rancho Cucamonga, CA 91739-9109
Phone (909) 916-0593

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

Practice roles

OrganizationSpecialtyStatusNew patients
888 Hbreal Estate Investments Corp CurrentSince May 28, 2023 Accepting new patients

Locations

350 S Milliken Ave
Ste L
Ontario, CA 91761
Phone (909) 916-0593

Organizations & group practices 1

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": "1684886400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684886400000",
    "number": "1598457780",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6288 GOLDEN TRAILS AVE",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917399109",
            "telephone_number": "909-916-0593",
            "fax_number": "909-542-3176"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 S MILLIKEN AVE STE L",
            "city": "ONTARIO",
            "state": "CA",
            "postal_code": "917617846",
            "telephone_number": "909-916-0593"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEREZ",
        "first_name": "MICHAEL",
        "middle_name": "RAE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-05-24",
        "last_updated": "2023-05-24",
        "certification_date": "2023-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "374K00000X",
            "taxonomy_group": "",
            "desc": "Religious Nonmedical Practitioner",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ontario, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.