Provider Demographics
NPI:1548409733
Name:PEREZ, YANIRA (MD)
Entity Type:Individual
Prefix:DR
First Name:YANIRA
Middle Name:
Last Name:PEREZ
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 1:850 S ATLANTIC BOULEVARD
Mailing Address - Street 2:STE 305
Mailing Address - City:MONTEREY PARK
Mailing Address - State:CA
Mailing Address - Zip Code:91754-6714
Mailing Address - Country:US
Mailing Address - Phone:626-570-6920
Mailing Address - Fax:626-282-3619
Practice Address - Street 1:850 S ATLANTIC BOULEVARD
Practice Address - Street 2:STE 305
Practice Address - City:MONTEREY PARK
Practice Address - State:CA
Practice Address - Zip Code:91754-6714
Practice Address - Country:US
Practice Address - Phone:626-570-6920
Practice Address - Fax:626-282-3619
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-11
Last Update Date:2015-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301092570208600000X
CAA119819208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
No208600000XAllopathic & Osteopathic PhysiciansSurgery