Provider Demographics
NPI:1013487883
Name:PERKINS, AUSTIN JAMES (PA-C, ATC)
Entity type:Individual
Prefix:
First Name:AUSTIN
Middle Name:JAMES
Last Name:PERKINS
Suffix:
Gender:M
Credentials:PA-C, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6180 OLD VILLAGE RD
Mailing Address - Street 2:
Mailing Address - City:YORBA LINDA
Mailing Address - State:CA
Mailing Address - Zip Code:92887-6704
Mailing Address - Country:US
Mailing Address - Phone:760-522-0040
Mailing Address - Fax:
Practice Address - Street 1:2141 N HARBOR BLVD STE 35000
Practice Address - Street 2:
Practice Address - City:FULLERTON
Practice Address - State:CA
Practice Address - Zip Code:92835-3831
Practice Address - Country:US
Practice Address - Phone:714-626-8630
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-12-04
Last Update Date:2021-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPA56332363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical