Provider Demographics
NPI:1194832725
Name:PERRY, ARTHUR C (MD)
Entity Type:Individual
Prefix:
First Name:ARTHUR
Middle Name:C
Last Name:PERRY
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 1:9850 GENESEE AVE
Mailing Address - Street 2:SUITE 310
Mailing Address - City:LA JOLLA
Mailing Address - State:CA
Mailing Address - Zip Code:92037-1224
Mailing Address - Country:US
Mailing Address - Phone:858-457-3010
Mailing Address - Fax:858-457-0028
Practice Address - Street 1:9850 GENESEE AVE
Practice Address - Street 2:SUITE 310
Practice Address - City:LA JOLLA
Practice Address - State:CA
Practice Address - Zip Code:92037-1224
Practice Address - Country:US
Practice Address - Phone:858-457-3010
Practice Address - Fax:858-457-0028
Is Sole Proprietor?:No
Enumeration Date:2006-08-23
Last Update Date:2008-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC37934207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00C379340Medicaid
CA00C379340Medicaid
CAWC37934CMedicare PIN