Provider Demographics
NPI:1194789230
Name:PERELES, FREDERICK SCOTT (MD)
Entity type:Individual
Prefix:DR
First Name:FREDERICK
Middle Name:SCOTT
Last Name:PERELES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:627 BRUNKEN AVE
Mailing Address - Street 2:SUITE A
Mailing Address - City:SALINAS
Mailing Address - State:CA
Mailing Address - Zip Code:93901-5002
Mailing Address - Country:US
Mailing Address - Phone:831-796-3740
Mailing Address - Fax:
Practice Address - Street 1:559 ABBOTT ST
Practice Address - Street 2:
Practice Address - City:SALINAS
Practice Address - State:CA
Practice Address - Zip Code:93901-4325
Practice Address - Country:US
Practice Address - Phone:831-775-5200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-04-14
Last Update Date:2008-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG872112085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G872110Medicaid
CA00G872110Medicaid
00G872110Medicare PIN