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Individual
MR. MARK A PEREZ
Active
Individual
MR. MARK A PEREZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
14517
NV
207Q00000X
Family Medicine Physician
G067514
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00G675140
BLUE SHIELD OF CA
CA
05
—
G00675140
—
CA
Enumeration date
11/17/2006
Last updated
08/14/2015
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