Provider Demographics
NPI:1346587938
Name:PEREIRA, SALOMON
Entity Type:Individual
Prefix:
First Name:SALOMON
Middle Name:
Last Name:PEREIRA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:GISELLE
Other - Middle Name:MEDICAL
Other - Last Name:TRANSPORT
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 3013
Mailing Address - Street 2:
Mailing Address - City:CATHEDRAL CITY
Mailing Address - State:CA
Mailing Address - Zip Code:92235-3013
Mailing Address - Country:US
Mailing Address - Phone:760-333-4662
Mailing Address - Fax:760-832-8739
Practice Address - Street 1:31055 AVENIDA DEL PADRE
Practice Address - Street 2:
Practice Address - City:CATHEDRAL CITY
Practice Address - State:CA
Practice Address - Zip Code:92234-3006
Practice Address - Country:US
Practice Address - Phone:760-333-4662
Practice Address - Fax:760-832-8739
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-15
Last Update Date:2013-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172A00000XOther Service ProvidersDriver