Active NPI
Rhoderick Pereyra
- Lodging Provider
- La Puente, CA
National Provider Identifier
1861364580
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Lodging Provider
- License
- 198603789
- Practice address
- 15753 Fellowship St
La Puente, CA 91744-1222 - Phone
- (626) 374-9450
- NPI assigned
- Sep 22, 2025
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Lodging Provider | 177F00000X | 198603789 | CA | Primary |
Addresses
Primary practice location
15753 Fellowship St
La Puente, CA 91744-1222
Mailing address
15753 Fellowship St
La Puente, CA 91744-1222
Phone (626) 374-9450
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 198603789 | CA | MD | Lodging Provider |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1758499200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1758499200000",
"number": "1861364580",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15753 FELLOWSHIP ST",
"city": "LA PUENTE",
"state": "CA",
"postal_code": "917441222",
"telephone_number": "626-374-9450"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15753 FELLOWSHIP ST",
"city": "LA PUENTE",
"state": "CA",
"postal_code": "917441222",
"telephone_number": "626-374-9450"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PEREYRA",
"first_name": "RHODERICK",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2025-09-22",
"last_updated": "2025-09-22",
"certification_date": "2025-09-22",
"status": "A"
},
"taxonomies": [
{
"code": "177F00000X",
"taxonomy_group": "",
"desc": "Lodging",
"state": "CA",
"license": "198603789",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in La Puente, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.