Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207P00000X | Emergency Physician | G58726 | CA |
NPI | 1013019678 |
---|---|
Provider Name | Dr. Matthew J. Perl |
First Address | San Diego, CA 92127-5705 |
Second Address | San Diego, CA 92128-3491 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/09/2006 |
Last Update Date | 14/02/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00G587260 | (05) | CA |
E74242 | (02) | CA |