Individual
DR. STEWART BERNARD PERRILLIAT II
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMIN
Contact information
Practice address
5416 SHALLOWS PL W, SANTA ROSA, CA 95409-5502
(408) 750-4334
(707) 703-5794
Mailing address
5416 SHALLOWS PL W, SANTA ROSA, CA 95409-5502
(408) 750-4334
(707) 703-5794
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
—
CA
374K00000X
Religious Nonmedical Practitioner
Primary
—
CA
Other
Enumeration date
10/15/2024
Last updated
10/15/2024
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