Organization
GREATER LONG BEACH GENITO-URINARY MED GRP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JULES M PERLEY MD (MD/PRESIDENT)
(562) 630-0423
Entity
Organization
Contact information
Practice address
3650 SOUTH STREET, SUITE 408, LAKEWOOD, CA 90712-1510
(562) 630-0423
(562) 630-0660
Mailing address
3650 SOUTH STREET, SUITE 408, LAKEWOOD, CA 90712-1510
(562) 630-0423
(562) 630-0660
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
G22223
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1326017831
PHYSICIAN INDIVIDUAL UPIN
CA
01
—
1497724900
PHYSICIAN INDIVIDUAL PIN
CA
01
—
1801865381
PHYSICIAN INDIVIDUAL PIN
CA
01
—
A76527
STATE LICENSE
CA
01
—
G22223
STATE LICENSE
CA
01
—
G54806
STATE LICENSE
CA
05
—
GR0049180
—
CA
01
—
WA76527A
MEDICARE INDIVIDUAL PROVI
CA
01
—
WA76527B
MEDICARE INDIVIDUAL PROVI
CA
01
—
WG22223A
MEDICARE INDIVIDUAL PROVI
CA
01
—
WG22223B
MEDICARE INDIVIDUAL PROVI
CA
01
—
WG54806C
MEDICARE INDIVIDUAL PROVI
CA
01
—
WG54806D
MEDICARE INDIVIDUAL PROVI
CA
Enumeration date
07/18/2006
Last updated
01/15/2010
Update your record
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