Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | A107880 | CA |
NPI | 1003041492 |
---|---|
Provider Name | Susan A. Perez |
First Address | Pasadena, CA 91103-1620 |
Second Address | Pasadena, CA 91103-1620 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/05/2009 |
Last Update Date | 06/12/2021 |