Provider Demographics
NPI:1013387059
Name:DAVID PERZ, DO INC.
Entity Type:Organization
Organization Name:DAVID PERZ, DO INC.
Other - Org Name:DAVID PERZ, D.O.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:DONNELL
Authorized Official - Last Name:PERZ
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:951-766-4329
Mailing Address - Street 1:2591 W FLORIDA AVE
Mailing Address - Street 2:
Mailing Address - City:HEMET
Mailing Address - State:CA
Mailing Address - Zip Code:92545-4615
Mailing Address - Country:US
Mailing Address - Phone:951-766-4329
Mailing Address - Fax:951-766-8056
Practice Address - Street 1:2591 W FLORIDA AVE
Practice Address - Street 2:
Practice Address - City:HEMET
Practice Address - State:CA
Practice Address - Zip Code:92545-4615
Practice Address - Country:US
Practice Address - Phone:951-766-4329
Practice Address - Fax:951-766-8056
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-02
Last Update Date:2015-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A8482261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAI09322Medicare UPIN