Provider Demographics
NPI:1245259845
Name:PERLADA, DAVID E (MD)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:E
Last Name:PERLADA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Last Name Type:
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Mailing Address - Street 1:1 COUNTRY CLUB PLZ
Mailing Address - Street 2:
Mailing Address - City:ORINDA
Mailing Address - State:CA
Mailing Address - Zip Code:94563-2308
Mailing Address - Country:US
Mailing Address - Phone:925-254-3805
Mailing Address - Fax:925-254-9783
Practice Address - Street 1:1 COUNTRY CLUB PLZ
Practice Address - Street 2:
Practice Address - City:ORINDA
Practice Address - State:CA
Practice Address - Zip Code:94563-2308
Practice Address - Country:US
Practice Address - Phone:925-254-3805
Practice Address - Fax:925-254-9783
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2008-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAC50989207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
00C509891OtherLEGACY ID
CA00C509890Medicaid
00C509891OtherLEGACY ID