Individual
DR. BENITO B PEREZ JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
12815 HEACOCK ST, MORENO VALLEY, CA 92553-3116
(951) 972-7393
Mailing address
12815 HEACOCK ST, MORENO VALLEY, CA 92553-3116
(951) 972-7393
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
01054872
IN
207Q00000X
Family Medicine Physician
Primary
C52990
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200361810
—
IN
Enumeration date
02/10/2006
Last updated
12/10/2021
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