Provider Demographics
NPI:1598452237
Name:PERRY, JAMES CLIFFORD II
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:CLIFFORD
Last Name:PERRY
Suffix:II
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1300 PARK NEWPORT APT 214
Mailing Address - Street 2:
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92660-5031
Mailing Address - Country:US
Mailing Address - Phone:775-420-2688
Mailing Address - Fax:
Practice Address - Street 1:1300 PARK NEWPORT APT 214
Practice Address - Street 2:
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92660-5031
Practice Address - Country:US
Practice Address - Phone:775-420-2688
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-21
Last Update Date:2023-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered