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Individual

DR. GREGORY PERENS X

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
10833 LE CONTE AVE, 12-441 MDCC, LOS ANGELES, CA 90095-3075
(310) 825-5296
(310) 825-9524
Mailing address
10833 LE CONTE AVE, 12-441 MDCC, LOS ANGELES, CA 90095-3075
(310) 825-5296
(310) 825-9524

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
A73878
CA
2080P0202X
Pediatric Cardiology Physician
Primary
A73878
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00A738780
CA
05
GR0053510
CA
Enumeration date
06/26/2006
Last updated
06/19/2012
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