Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NX0100X | Occupational Health | 0024556 | CA |
NPI | 1194256651 |
---|---|
Provider Name | Dr. James Perry Perkins JR. |
First Address | Riverside, CA 92507-2606 |
Second Address | Riverside, CA 92507-2606 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/03/2017 |
Last Update Date | 24/03/2017 |