Provider Demographics
NPI:1043832272
Name:TODD L PERLMUTTER, INC
Entity Type:Organization
Organization Name:TODD L PERLMUTTER, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PERLMUTTER
Authorized Official - Prefix:
Authorized Official - First Name:TODD
Authorized Official - Middle Name:LUCAS
Authorized Official - Last Name:PERLMUTTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-259-1601
Mailing Address - Street 1:5737 KANAN RD STE 285
Mailing Address - Street 2:
Mailing Address - City:AGOURA HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91301-1601
Mailing Address - Country:US
Mailing Address - Phone:818-597-0115
Mailing Address - Fax:818-889-5058
Practice Address - Street 1:29395 AGOURA RD STE 209
Practice Address - Street 2:
Practice Address - City:AGOURA HILLS
Practice Address - State:CA
Practice Address - Zip Code:91301-2599
Practice Address - Country:US
Practice Address - Phone:818-597-0115
Practice Address - Fax:818-889-5058
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-11
Last Update Date:2020-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health