Individual
JOSE IGNACIO PEREA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
12300 WILSHIRE BLVD STE 404, LOS ANGELES, CA 90025-1061
(310) 207-2272
(424) 293-2623
Mailing address
12300 WILSHIRE BLVD STE 404, LOS ANGELES, CA 90025-1061
(310) 207-2272
(424) 293-2623
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
48537
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1942536586
—
CA
Enumeration date
07/31/2018
Last updated
07/31/2018
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