Active NPI
Mark Bautista Perez, RN
- Emergency Registered Nurse
- Oakland, CA
National Provider Identifier
1952733883
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Registered Nurse
- License
- 646488
- Practice address
- 9417 Dunbar Dr
Oakland, CA 94603-3014 - Phone
- (510) 846-1163
- Fax
- (510) 846-1163
- NPI assigned
- Aug 1, 2013
- Last updated
- Aug 1, 2013
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Emergency Registered Nurse | 163WE0003X | 646488 | CA | Primary |
Addresses
Primary practice location
9417 Dunbar Dr
Oakland, CA 94603-3014
Mailing address
9417 Dunbar Dr
Oakland, CA 94603-3014
Phone (510) 846-1163
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
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 646488 | CA | MD | Emergency Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1375315200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1375315200000",
"number": "1952733883",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9417 DUNBAR DR",
"city": "OAKLAND",
"state": "CA",
"postal_code": "946033014",
"telephone_number": "510-846-1163",
"fax_number": "510-846-1163"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9417 DUNBAR DR",
"city": "OAKLAND",
"state": "CA",
"postal_code": "946033014",
"telephone_number": "510-846-1163",
"fax_number": "510-846-1163"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PEREZ",
"first_name": "MARK",
"middle_name": "BAUTISTA",
"credential": "RN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2013-08-01",
"last_updated": "2013-08-01",
"status": "A"
},
"taxonomies": [
{
"code": "163WE0003X",
"taxonomy_group": "",
"desc": "Registered Nurse, Emergency",
"state": "CA",
"license": "646488",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Oakland, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.