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Individual

MR. PEIRUCH PERRY WICH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
630 N 13TH AVE, SUITE F, UPLAND, CA 91786-4975
(909) 946-3826
(909) 949-4457
Mailing address
630 N 13TH AVE, SUITE F, UPLAND, CA 91786-4975
(909) 946-3826
(909) 949-4457

Taxonomy

Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
A32660
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
8208912
CA
Enumeration date
09/20/2006
Last updated
07/08/2007
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