Provider Demographics
NPI:1831475862
Name:RICARDO PEREZ, MD, A PROFESSIONAL CORPORATION
Entity Type:Organization
Organization Name:RICARDO PEREZ, MD, A PROFESSIONAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARGARET
Authorized Official - Middle Name:
Authorized Official - Last Name:PEREZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:408-779-0668
Mailing Address - Street 1:760 ENCINO DR
Mailing Address - Street 2:
Mailing Address - City:MORGAN HILL
Mailing Address - State:CA
Mailing Address - Zip Code:95037-5802
Mailing Address - Country:US
Mailing Address - Phone:408-779-0668
Mailing Address - Fax:408-778-6838
Practice Address - Street 1:17600 MONTEREY RD
Practice Address - Street 2:SUITE A
Practice Address - City:MORGAN HILL
Practice Address - State:CA
Practice Address - Zip Code:95037-3669
Practice Address - Country:US
Practice Address - Phone:408-779-0668
Practice Address - Fax:408-778-6838
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-21
Last Update Date:2012-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG38927261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care