Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225400000X | Rehabilitation Practitioner |
NPI | 1023137304 |
---|---|
Provider Name | Benzion Isa Perez |
First Address | Visalia, CA 93277-4418 |
Second Address | Montclair, CA 91763-2952 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/03/2007 |
Last Update Date | 23/11/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
7564A | THE VILLAGE FAMILY SERVICES (01) | CA |
7817A | CHILDREN'S INSTITIUTE, INC (01) | CA |