Basic Information
| Provider Information | |||||||||
| NPI: | 1952600264 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | PEREZ | ||||||||
| FirstName: | FRANCISCO | ||||||||
| MiddleName: | JAVIER | ||||||||
| NamePrefix: | MR. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5134 1/2 ITHACA AVE | ||||||||
| Address2: | |||||||||
| City: | LOS ANGELES | ||||||||
| State: | CA | ||||||||
| PostalCode: | 900323353 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8189897475 | ||||||||
| FaxNumber: | 8187813822 | ||||||||
| Practice Location | |||||||||
| Address1: | 14411 VANOWEN ST | ||||||||
| Address2: | |||||||||
| City: | VAN NUYS | ||||||||
| State: | CA | ||||||||
| PostalCode: | 914054038 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8189897475 | ||||||||
| FaxNumber: | 8187813822 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/25/2011 | ||||||||
| LastUpdateDate: | 03/25/2011 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225400000X | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Rehabilitation Practitioner |
No ID Information.