Provider Demographics
NPI:1780796235
Name:PERLMAN, MONICA (MD)
Entity type:Individual
Prefix:DR
First Name:MONICA
Middle Name:
Last Name:PERLMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9850 GENESEE AVE
Mailing Address - Street 2:SUITE 320
Mailing Address - City:LA JOLLA
Mailing Address - State:CA
Mailing Address - Zip Code:92037-1224
Mailing Address - Country:US
Mailing Address - Phone:858-554-1212
Mailing Address - Fax:858-554-1222
Practice Address - Street 1:9850 GENESEE AVE
Practice Address - Street 2:SUITE 320
Practice Address - City:LA JOLLA
Practice Address - State:CA
Practice Address - Zip Code:92037
Practice Address - Country:US
Practice Address - Phone:858-554-1212
Practice Address - Fax:858-554-1222
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2018-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG703562083P0901X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No2083P0901XAllopathic & Osteopathic PhysiciansPreventive MedicinePublic Health & General Preventive Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAF21314Medicare UPIN
CAF21314Medicare UPIN