Provider Demographics
NPI:1073189940
Name:PERKOVIC, TONIO
Entity Type:Individual
Prefix:
First Name:TONIO
Middle Name:
Last Name:PERKOVIC
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:TONIO
Other - Middle Name:
Other - Last Name:GALOIC
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:9015 MURRAY AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:GILROY
Mailing Address - State:CA
Mailing Address - Zip Code:95020-3675
Mailing Address - Country:US
Mailing Address - Phone:408-842-7138
Mailing Address - Fax:408-842-0383
Practice Address - Street 1:9015 MURRAY AVE STE 100
Practice Address - Street 2:
Practice Address - City:GILROY
Practice Address - State:CA
Practice Address - Zip Code:95020-3675
Practice Address - Country:US
Practice Address - Phone:408-842-7138
Practice Address - Fax:408-842-0383
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-01
Last Update Date:2021-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator