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:
Health care specialties
| Specialty | Code | License # | 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1871566778 | NPPES |
| Indiana | MEDICAID | 200361810 |
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