Provider Demographics
NPI:1114107109
Name:PEREZ, VICTOR M (MD)
Entity Type:Individual
Prefix:DR
First Name:VICTOR
Middle Name:M
Last Name:PEREZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:114 ETTON CT
Mailing Address - Street 2:SUITE 403C
Mailing Address - City:SINAJANA
Mailing Address - State:GU
Mailing Address - Zip Code:96910-3224
Mailing Address - Country:US
Mailing Address - Phone:671-988-8040
Mailing Address - Fax:
Practice Address - Street 1:238 ARCHBISHOP FLORES ST
Practice Address - Street 2:SUITE 403C
Practice Address - City:HAGATNA
Practice Address - State:GU
Practice Address - Zip Code:96910-5206
Practice Address - Country:US
Practice Address - Phone:671-477-4619
Practice Address - Fax:671-477-4619
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-07
Last Update Date:2017-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GUM0008932084P0800X
GUM8932084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry