Provider Demographics
NPI:1518159805
Name:PERRY, DENIS MICHAEL (MD)
Entity Type:Individual
Prefix:DR
First Name:DENIS
Middle Name:MICHAEL
Last Name:PERRY
Suffix:
Gender:M
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:PO BOX 379
Mailing Address - Street 2:
Mailing Address - City:ATASCADERO
Mailing Address - State:CA
Mailing Address - Zip Code:93423-0379
Mailing Address - Country:US
Mailing Address - Phone:805-466-8311
Mailing Address - Fax:
Practice Address - Street 1:292 POSADA LN
Practice Address - Street 2:SUITE D
Practice Address - City:TEMPLETON
Practice Address - State:CA
Practice Address - Zip Code:93465-4054
Practice Address - Country:US
Practice Address - Phone:805-434-3211
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-08-10
Last Update Date:2011-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG30641207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine