Individual provider Active NPI

Adriana Sofia Perilla, M.D.

  • Neurology Physician
  • El Cajon, CA
National Provider Identifier
1871911552
Registry record updated Mar 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
A152822 Issued in CA
Practice address
533 Willet St
El Cajon, CA 92020-3837
Phone
(951) 852-4104
Fax
(952) 209-6735
NPI assigned
Mar 31, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 9, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X 1871911552 IL
Neurology Physician 2084N0400X A152822 CA Primary

Addresses

Primary practice location

533 Willet St
El Cajon, CA 92020-3837

Mailing address

533 Willet St
El Cajon, CA 92020-3837
Phone (951) 852-4104

Other practice location 1

2160 S 1st Ave
Loyola Outpatient Center, 4300
Maywood, IL 60153-3328
Phone (708) 216-6006

Other practice location 2

425 E Colorado St
Glendale, CA 91205-5117
Phone (847) 564-8500 ext. 6180

Other practice location 3

127 S San Vicente Blvd # A-6600
Los Angeles, CA 90048
Phone (310) 423-6472

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A152822CAMDNeurology Physician
1871911552ILMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Loyola University Medical Center Past Accepting new patients

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": "1396224000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615248000000",
    "number": "1871911552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "533 WILLET ST",
            "city": "EL CAJON",
            "state": "CA",
            "postal_code": "920203837",
            "telephone_number": "951-852-4104",
            "fax_number": "952-209-6735"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "533 WILLET ST",
            "city": "EL CAJON",
            "state": "CA",
            "postal_code": "920203837",
            "telephone_number": "951-852-4104",
            "fax_number": "952-209-6735"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2160 S 1st Ave",
            "address_2": "Loyola Outpatient Center, 4300",
            "address_purpose": "LOCATION",
            "city": "Maywood",
            "state": "IL",
            "postal_code": "601533328",
            "country_code": "US",
            "telephone_number": "708-216-6006",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "425 E Colorado St",
            "address_purpose": "LOCATION",
            "city": "Glendale",
            "state": "CA",
            "postal_code": "912055117",
            "country_code": "US",
            "telephone_number": "847-564-8500 x6180",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "127 S San Vicente Blvd # A-6600",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "90048",
            "country_code": "US",
            "telephone_number": "310-423-6472",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PERILLA",
        "first_name": "ADRIANA SOFIA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-03-31",
        "last_updated": "2021-03-09",
        "certification_date": "2021-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "IL",
            "license": "1871911552",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "CA",
            "license": "A152822",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in El Cajon, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2021; 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.