Provider Demographics
NPI:1346402559
Name:PERLMAN, STUART DAVID (PHD)
Entity Type:Individual
Prefix:DR
First Name:STUART
Middle Name:DAVID
Last Name:PERLMAN
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12304 SANTA MONICA BLVD STE 108
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90025-2586
Mailing Address - Country:US
Mailing Address - Phone:310-820-8415
Mailing Address - Fax:
Practice Address - Street 1:12304 SANTA MONICA BLVD STE 108
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90025-2586
Practice Address - Country:US
Practice Address - Phone:310-820-8415
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-29
Last Update Date:2008-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY7274103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical