Individual
MR. MARK A PEREZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4275 BURNHAM AVE. SUITE 210, LAS VEGAS, NV 89119-5488
(702) 384-7669
(702) 385-7669
Mailing address
4275 BURNHAM AVE, SUITE 210, LAS VEGAS, NV 89119-5488
(702) 384-7669
(702) 385-7669
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
14517
NV
207Q00000X
Family Medicine Physician
G067514
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00G675140
BLUE SHIELD OF CA
CA
05
—
G00675140
—
CA
Enumeration date
11/17/2006
Last updated
08/14/2015
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