Provider Demographics
NPI:1043498066
Name:PEREZ, MARTHA ALEXANDRA (AA)
Entity Type:Individual
Prefix:
First Name:MARTHA
Middle Name:ALEXANDRA
Last Name:PEREZ
Suffix:
Gender:F
Credentials:AA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9101 WHITTIER BLVD
Mailing Address - Street 2:
Mailing Address - City:PICO RIVERA
Mailing Address - State:CA
Mailing Address - Zip Code:90660-2405
Mailing Address - Country:US
Mailing Address - Phone:562-801-4626
Mailing Address - Fax:562-801-4630
Practice Address - Street 1:9101 WHITTIER BLVD
Practice Address - Street 2:
Practice Address - City:PICO RIVERA
Practice Address - State:CA
Practice Address - Zip Code:90660-2444
Practice Address - Country:US
Practice Address - Phone:562-801-4626
Practice Address - Fax:562-801-4630
Is Sole Proprietor?:No
Enumeration Date:2008-01-31
Last Update Date:2011-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner