Individual provider Active NPI

Desmond Duval Perry

  • Driver
  • La Mesa, CA
National Provider Identifier
1609602424
Registry record updated Oct 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
DriverTaxonomy code 172A00000X
Practice address
8750 Mellmanor Dr Apt 54
La Mesa, CA 91942-3165
Phone
(619) 581-2812
NPI assigned
Sep 9, 2024
Last updated
Oct 1, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Driver 172A00000X Primary

Addresses

Primary practice location

8750 Mellmanor Dr Apt 54
La Mesa, CA 91942-3165

Mailing address

8750 Mellmanor Dr Apt 54
La Mesa, CA 91942-3165
Phone (619) 581-2812

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": "1725840000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727740800000",
    "number": "1609602424",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8750 MELLMANOR DR APT 54",
            "city": "LA MESA",
            "state": "CA",
            "postal_code": "919423165",
            "telephone_number": "619-581-2812"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8750 MELLMANOR DR APT 54",
            "city": "LA MESA",
            "state": "CA",
            "postal_code": "919423165",
            "telephone_number": "619-581-2812"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERRY",
        "first_name": "DESMOND",
        "middle_name": "DUVAL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-09-09",
        "last_updated": "2024-10-01",
        "certification_date": "2024-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172A00000X",
            "taxonomy_group": "",
            "desc": "Driver",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in La Mesa, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2024; 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.