Provider Demographics
NPI:1932654100
Name:PEREZ, ADAM
Entity Type:Individual
Prefix:
First Name:ADAM
Middle Name:
Last Name:PEREZ
Suffix:
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 1:2414 S FAIRVIEW ST
Mailing Address - Street 2:SUITE 202-B
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92704-5318
Mailing Address - Country:US
Mailing Address - Phone:855-743-8722
Mailing Address - Fax:185-574-3872
Practice Address - Street 1:2414 S FAIRVIEW ST
Practice Address - Street 2:SUITE 202-B
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92704-5318
Practice Address - Country:US
Practice Address - Phone:855-743-8722
Practice Address - Fax:185-574-3872
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-17
Last Update Date:2016-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1200XAmbulatory Health Care FacilitiesClinic/CenterMagnetic Resonance Imaging (MRI)