Mark D Perrault, M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

A43550 Issued in CA

Practice address

11111 Jefferson Blvd
5005
Culver City, CA 90230-6903

Phone

(323) 736-0977

Fax

(310) 733-1835

NPI assigned

Oct 26, 2009

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1256515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641859200000",
    "number": "1649506643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3940 OLMSTED AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900082626",
            "telephone_number": "323-736-0977",
            "fax_number": "310-733-1835"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11111 JEFFERSON BLVD",
            "address_2": "5005",
            "city": "CULVER CITY",
            "state": "CA",
            "postal_code": "902306903",
            "telephone_number": "323-736-0977",
            "fax_number": "310-733-1835"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERRAULT",
        "first_name": "MARK",
        "middle_name": "D",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-10-26",
        "last_updated": "2022-01-11",
        "certification_date": "2022-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "A43550",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "a1.fitness.perrault@protonmail.com",
            "affiliation": "N",
            "endpointDescription": "encrypted email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "11111 Jefferson Blvd # 5005",
            "city": "Culver City",
            "state": "CA",
            "country_code": "US",
            "postal_code": "902305561",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Trennan Noelle Perez
• Moneshia R Perkins
• Tiffany Monique Perkins
• Trashon Perkins
• Lorencita Perlmutter, SLPA
• Jason W Perry
• Doris Jean Person
• Gina Marie Pesapane, LMFT
• Julianna Ellen Pesce, M.D.
• Noah Kojo Peter

• Psychiatry Physician in Culver City, CA
• Providers in Culver City, CA by specialty
• Psychiatry Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.