Basic Information
| Provider Information | |||||||||
| NPI: | 1215458153 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | MONICA PERLMAN MD INC. | ||||||||
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| OtherOrganizationName: | PERLMAN CLINIC | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 9850 GENESEE AVE | ||||||||
| Address2: | SUITE 320 | ||||||||
| City: | LA JOLLA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 920371208 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8585541212 | ||||||||
| FaxNumber: | 8585541222 | ||||||||
| Practice Location | |||||||||
| Address1: | 4142 ADAMS AVE STE 102 | ||||||||
| Address2: | |||||||||
| City: | SAN DIEGO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 921162593 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8586170717 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/30/2017 | ||||||||
| LastUpdateDate: | 09/30/2019 | ||||||||
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| AuthorizedOfficialLastName: | PERLMAN | ||||||||
| AuthorizedOfficialFirstName: | MITCHELL | ||||||||
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| AuthorizedOfficialTitleorPosition: | CEO | ||||||||
| AuthorizedOfficialTelephone: | 8585541212 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 544547 | CA | N | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Family Medicine | 207R00000X | 544547 | CA | N | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | 261QU0200X | 544547 | CA | N | Ambulatory Health Care Facilities | Clinic/Center | Urgent Care | 261QP2300X | G70356 | CA | Y | Ambulatory Health Care Facilities | Clinic/Center | Primary Care |
No ID Information.