Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207W00000X | Ophthalmologist | 01066189A | IN |
N | 207W00000X | Ophthalmologist | 60122633 | WA |
N | 207W00000X | Ophthalmologist | A76921 | CA |
NPI | 1003917402 |
---|---|
Provider Name | Carlindo Da Reitz Pereira |
First Address | Mount Vernon, WA 98274-8752 |
Second Address | Mount Vernon, WA 98274-8752 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/09/2006 |
Last Update Date | 02/12/2020 |