Provider Demographics
NPI:1952464711
Name:PERKINS, GERALDINE H (MAT)
Entity Type:Individual
Prefix:
First Name:GERALDINE
Middle Name:H
Last Name:PERKINS
Suffix:
Gender:F
Credentials:MAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:550 S VERMONT AVE
Mailing Address - Street 2:3RD FLR
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90020
Mailing Address - Country:US
Mailing Address - Phone:310-482-6600
Mailing Address - Fax:310-313-0813
Practice Address - Street 1:11303 W. WASHINGTON BLVD,
Practice Address - Street 2:#200
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90066
Practice Address - Country:US
Practice Address - Phone:310-482-6612
Practice Address - Fax:310-313-0813
Is Sole Proprietor?:No
Enumeration Date:2006-12-19
Last Update Date:2014-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator