Provider Demographics
NPI:1578570016
Name:PERLMAN, ORREN Z (MD)
Entity Type:Individual
Prefix:
First Name:ORREN
Middle Name:Z
Last Name:PERLMAN
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 1:101 H ST
Mailing Address - Street 2:SUITE N
Mailing Address - City:PETALUMA
Mailing Address - State:CA
Mailing Address - Zip Code:94952-5152
Mailing Address - Country:US
Mailing Address - Phone:707-523-9423
Mailing Address - Fax:707-542-9423
Practice Address - Street 1:101 H ST
Practice Address - Street 2:SUITE N
Practice Address - City:PETALUMA
Practice Address - State:CA
Practice Address - Zip Code:94952-5152
Practice Address - Country:US
Practice Address - Phone:707-523-9423
Practice Address - Fax:707-542-9423
Is Sole Proprietor?:No
Enumeration Date:2006-08-01
Last Update Date:2015-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA531952084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAFHC03899GMedicaid
ZZZ21461ZOtherMEDICARE PART B
00A531951OtherMEDICARE ID
CAA53195OtherSTATE LICENSE NUMBER
CAFHC03887FMedicaid
CAFHC03887FMedicaid
CAFHC03899GMedicaid
ZZZ21461ZOtherMEDICARE PART B