Individual provider Active NPI

Nicholas Joseph Perez, NP

  • Family Nurse Practitioner
  • Fontana, CA
National Provider Identifier
1790502896
Registry record updated Sep 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95032167 Issued in CA
Practice address
5680 Kate Way Unit 5
Fontana, CA 92336-4677
Phone
(909) 851-7242
NPI assigned
Sep 21, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 21, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 95032167 CA Primary

Addresses

Primary practice location

5680 Kate Way Unit 5
Fontana, CA 92336-4677

Mailing address

5680 Kate Way Unit 5
Fontana, CA 92336-4677
Phone (909) 851-7242

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
I20250313003104 CA Practitioner - Nurse Practitioner 3779005210 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dalia Dawoud MD IncGroup PAC ID 7012370265, 19 clinicians

Practice addresses (Care Compare)

30465 Avenida de Las Flores
Suite a
Rancho Santa Margarita, CA 92688-3937
Phone (949) 264-6001

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Dalia Dawoud MD Inc CurrentSince Mar 5, 2025 Accepting new patients
Dalia Dawoud MD Inc Current Accepting new patients
Dalia Dawoud MD Inc Current Accepting new patients

Locations

4200 Chino Hills Pkwy
Ste 800
Chino Hills, CA 91709
Phone (909) 606-6559

2790 Cabot Dr
Ste 145
Corona, CA 92883
Phone (951) 603-3030

30465 Avenida de las Flores
Ste A
Rancho Santa Margarita, CA 92688
Phone (949) 264-6001

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": "1726876800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726876800000",
    "number": "1790502896",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5680 KATE WAY UNIT 5",
            "city": "FONTANA",
            "state": "CA",
            "postal_code": "923364677",
            "telephone_number": "909-851-7242"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5680 KATE WAY UNIT 5",
            "city": "FONTANA",
            "state": "CA",
            "postal_code": "923364677",
            "telephone_number": "909-851-7242"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEREZ",
        "first_name": "NICHOLAS",
        "middle_name": "JOSEPH",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-09-21",
        "last_updated": "2024-09-21",
        "certification_date": "2024-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95032167",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fontana, CA

Sources for this page

Verify at the official NPI Registry.