Provider Demographics
NPI:1073857413
Name:PERLOW MEDICAL CORPORATION
Entity Type:Organization
Organization Name:PERLOW MEDICAL CORPORATION
Other - Org Name:REBECCA LEE PERLOW D.O.
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:PERLOW
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:818-344-8822
Mailing Address - Street 1:18321 VENTURA BLVD STE 580
Mailing Address - Street 2:
Mailing Address - City:TARZANA
Mailing Address - State:CA
Mailing Address - Zip Code:91356-6435
Mailing Address - Country:US
Mailing Address - Phone:818-344-8822
Mailing Address - Fax:818-975-1118
Practice Address - Street 1:18321 VENTURA BLVD STE 580
Practice Address - Street 2:
Practice Address - City:TARZANA
Practice Address - State:CA
Practice Address - Zip Code:91356-6435
Practice Address - Country:US
Practice Address - Phone:818-344-8822
Practice Address - Fax:818-975-1118
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-26
Last Update Date:2022-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A6634207V00000X, 207VX0000X
CAA21097207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
No207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologyGroup - Single Specialty
No207VX0000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyObstetricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1073857413OtherGROUP NPI PERLOW MEDICAL CORPORATION
CA1346235157OtherNPI INDIVIDUAL REBECCA L PERLOW DO
CA1033104823OtherNPI DENNIS L PERLOW MD
CA1033104823OtherNPI DENNIS L PERLOW MD