Provider Demographics
NPI:1912111873
Name:PERLROTH, CHI LEE (MD)
Entity Type:Individual
Prefix:DR
First Name:CHI
Middle Name:LEE
Last Name:PERLROTH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:CHI
Other - Middle Name:LEE
Other - Last Name:PERLROTH
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:1015 KIRKCREST LN
Mailing Address - Street 2:
Mailing Address - City:ALAMO
Mailing Address - State:CA
Mailing Address - Zip Code:94507-2465
Mailing Address - Country:US
Mailing Address - Phone:213-810-4785
Mailing Address - Fax:
Practice Address - Street 1:1601 YGNACIO VALLEY RD
Practice Address - Street 2:JOHN MUIR MEDICAL CENTER EMERGENCY DEPT
Practice Address - City:WALNUT CREEK
Practice Address - State:CA
Practice Address - Zip Code:94598-3122
Practice Address - Country:US
Practice Address - Phone:925-939-5800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-10
Last Update Date:2020-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA90104207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine