Provider Demographics
NPI:1770132128
Name:PEREZ, ROSARIO
Entity type:Individual
Prefix:
First Name:ROSARIO
Middle Name:
Last Name:PEREZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6551 WARNER AVE APT 1
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTN BCH
Mailing Address - State:CA
Mailing Address - Zip Code:92647-7930
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6551 WARNER AVE APT 1
Practice Address - Street 2:
Practice Address - City:HUNTINGTN BCH
Practice Address - State:CA
Practice Address - Zip Code:92647-7930
Practice Address - Country:US
Practice Address - Phone:562-481-7317
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-09
Last Update Date:2019-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer