Provider Demographics
NPI:1740524040
Name:PERLOW MEDICAL CORP
Entity type:Organization
Organization Name:PERLOW MEDICAL CORP
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DENNIS
Authorized Official - Middle Name:LEONARD
Authorized Official - Last Name:PERLOW
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:818-344-8822
Mailing Address - Street 1:5525 ETIWANDA AVE
Mailing Address - Street 2:#209
Mailing Address - City:TARZANA
Mailing Address - State:CA
Mailing Address - Zip Code:91356-3647
Mailing Address - Country:US
Mailing Address - Phone:818-344-8822
Mailing Address - Fax:818-344-8822
Practice Address - Street 1:5525 ETIWANDA AVE
Practice Address - Street 2:#209
Practice Address - City:TARZANA
Practice Address - State:CA
Practice Address - Zip Code:91356-3647
Practice Address - Country:US
Practice Address - Phone:818-344-8822
Practice Address - Fax:818-344-8822
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-27
Last Update Date:2012-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA21097207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1033104823OtherINDIVIDUAL NPI
CA1033104823OtherINDIVIDUAL NPI