Provider Demographics
NPI:1326017831
Name:PERLEY, JONATHAN E (MD)
Entity Type:Individual
Prefix:DR
First Name:JONATHAN
Middle Name:E
Last Name:PERLEY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:3650 SOUTH ST
Mailing Address - Street 2:#408
Mailing Address - City:LAKEWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:90712-1502
Mailing Address - Country:US
Mailing Address - Phone:562-630-0423
Mailing Address - Fax:562-630-0660
Practice Address - Street 1:3650 SOUTH ST
Practice Address - Street 2:#408
Practice Address - City:LAKEWOOD
Practice Address - State:CA
Practice Address - Zip Code:90712-1502
Practice Address - Country:US
Practice Address - Phone:562-630-0423
Practice Address - Fax:562-630-0660
Is Sole Proprietor?:No
Enumeration Date:2006-03-16
Last Update Date:2007-07-13
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAA76527208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA76527OtherCALIFORNIA MEDICAL LICENS
CAA76527OtherCALIFORNIA MEDICAL LICENS