Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 204C00000X | Sports Medicine Doctor | 20A8714 | CA |
Y | 207XS0117X | Orthopaedic Spine Surgeon | 20A8714 | CA |
NPI | 1215943444 |
---|---|
Provider Name | Brian Regis Perri |
First Address | Los Angeles, CA 90048 |
Second Address | Los Angeles, CA 90048 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/07/2006 |
Last Update Date | 08/12/2016 |