| John M. Peric Md Inc | |
|
2701 W Alameda Ave Suite 403 Burbank CA 91505-4402 | |
| (818) 570-0542 | |
| (818) 558-1156 |
| Full Name | John M. Peric Md Inc |
|---|---|
| Speciality | Family Medicine |
| Location | 2701 W Alameda Ave, Burbank, California |
| Authorized Official Name and Position | John Mario Peric (MD, OWNER) |
| Authorized Official Contact | 8185700542 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| John M. Peric Md Inc 11333 Moorpark St #188 Studio City CA 91602-2618 Ph: (818) 570-0542 | John M. Peric Md Inc 2701 W Alameda Ave Suite 403 Burbank CA 91505-4402 Ph: (818) 570-0542 |
| NPI Number | 1770862856 |
|---|---|
| Provider Enumeration Date | 08/08/2011 |
| Last Update Date | 08/08/2011 |
| Medicare PECOS PAC ID | 2163694779 |
|---|---|
| Medicare Enrollment ID | O20111004000147 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770862856 | NPI | - | NPPES |
| A79419 | Other | CA | LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (California) | Primary |
| Provider Name | John M Peric |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1285664664 PECOS PAC ID: 9638070352 Enrollment ID: I20040115001187 |
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