Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VG0400X | Gynecologist | A21097 | CA |
NPI | 1033104823 |
---|---|
Provider Name | Dr. Dennis L Perlow |
First Address | Tarzana, CA 91356-3647 |
Second Address | Tarzana, CA 91356-3647 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/09/2005 |
Last Update Date | 29/04/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
A22455 | (02) | CA |