Organization
MARK PEREZ , M.D.
Active
Parent organization
SAN PEDRO HEALING ARTS MEDICAL CLINIC INC
Other names
Mark Perez MD
Organization subpart
Yes
Provider details
NPI number
Legal business name
SAN PEDRO HEALING ARTS MEDICAL CLINIC INC
Authorized official
DR. MARIA E BAEZ RND DPM LAC (CEO)
(310) 547-2197
Entity
Organization
Contact information
Practice address
1366 W 7TH ST, SUITE 4-B, SAN PEDRO, CA 90732-3500
(310) 547-2197
Mailing address
1366 W. 7TH ST, SUITE 4-B, SAN PEDRO, CA 90732-3500
(310) 547-2197
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
G67514
CA
261Q00000X
Clinic/Center
Primary
G067514
CA
363A00000X
Physician Assistant
PA21347
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
G67514
MEDICAL BOARD
CA
Enumeration date
03/10/2011
Last updated
03/06/2014
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