Perez, Benito B

Perez, Benito B is an sole proprietor health care provider with primary practice located at 12815 Heacock St , Moreno Valley CA 92553-3116. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Perez, Benito B can be contacted via phone (951) 972-7393.

Contact Information

Primary practice address
12815 Heacock St Moreno Valley CA 92553-3116
Phone: (951) 972-7393
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 01054872 Indiana
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X C52990 California

Profile Details

NPI number 1871566778
LBN Legal business name Perez, Benito B
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Feb 10th, 2006
Last updated Dec 10th, 2021 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1871566778 NPPES
Indiana MEDICAID 200361810

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