Jose Ignacio Perea Inc | |
12300 Wilshire Blvd. Ste#404 Los Angeles CA 90025-0000 | |
(310) 207-2272 | |
(310) 207-2273 |
Full Name | Jose Ignacio Perea Inc |
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Speciality | Clinic/center - Dental |
Location | 12300 Wilshire Blvd. Ste#404, Los Angeles, California |
Authorized Official Name and Position | Jose Perea (PRESIDENT) |
Authorized Official Contact | 3102072272 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Jose Ignacio Perea Inc 12300 Wilshire Blvd. Ste# 404 Los Angeles CA 90025 Ph: (310) 207-2272 | Jose Ignacio Perea Inc 12300 Wilshire Blvd. Ste#404 Los Angeles CA 90025-0000 Ph: (310) 207-2272 |
NPI Number | 1942536586 |
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Provider Enumeration Date | 11/02/2009 |
Last Update Date | 01/19/2018 |
Identifier | Type | State | Issuer |
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1942536586 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QD0000X | Clinic/center - Dental | 48537 (California) | Primary |
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