Provider Demographics
NPI:1437272440
Name:PEREIRA, BETHANIE ERIN (MD)
Entity Type:Individual
Prefix:DR
First Name:BETHANIE
Middle Name:ERIN
Last Name:PEREIRA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1301 N TUSTIN AVE
Mailing Address - Street 2:
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92705-8619
Mailing Address - Country:US
Mailing Address - Phone:714-953-3331
Mailing Address - Fax:714-953-4542
Practice Address - Street 1:1301 N. TUSTIN AVE
Practice Address - Street 2:
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92705
Practice Address - Country:US
Practice Address - Phone:174-953-3331
Practice Address - Fax:714-953-4542
Is Sole Proprietor?:No
Enumeration Date:2007-04-06
Last Update Date:2015-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC55815207PE0004X
AZ38101207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207PE0004XAllopathic & Osteopathic PhysiciansEmergency MedicineEmergency Medical Services
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine