Provider Demographics
NPI:1508555723
Name:PERLAS, BERNADINE ANNE (RN)
Entity Type:Individual
Prefix:
First Name:BERNADINE
Middle Name:ANNE
Last Name:PERLAS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5901 W CENTURY BLVD STE 750
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90045-5443
Mailing Address - Country:US
Mailing Address - Phone:323-480-4075
Mailing Address - Fax:
Practice Address - Street 1:301 N PRAIRIE AVE STE 202
Practice Address - Street 2:
Practice Address - City:INGLEWOOD
Practice Address - State:CA
Practice Address - Zip Code:90301-4509
Practice Address - Country:US
Practice Address - Phone:323-480-4075
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-03
Last Update Date:2023-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95307719163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse