Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0103X | Foot & Ankle Surgery | E5343 | CA |
NPI | 1033642749 |
---|---|
Provider Name | Dr. Alexander Rafael Perez |
First Address | Hermosa Beach, CA 90254-4604 |
Second Address | Hermosa Beach, CA 90254-4604 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/04/2017 |
Last Update Date | 10/04/2017 |