Provider Demographics
NPI:1205111978
Name:PEREZ-OLIMAN, JOSE SALVADOR
Entity type:Individual
Prefix:MR
First Name:JOSE
Middle Name:SALVADOR
Last Name:PEREZ-OLIMAN
Suffix:
Gender:M
Credentials:
Other - Prefix:MRS
Other - First Name:MARIA
Other - Middle Name:ANGELES
Other - Last Name:PEREZ
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1277 ERRINGER RD
Mailing Address - Street 2:
Mailing Address - City:SIMI VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:93065
Mailing Address - Country:US
Mailing Address - Phone:805-428-9246
Mailing Address - Fax:805-915-0422
Practice Address - Street 1:1277 ERRINGER RD
Practice Address - Street 2:
Practice Address - City:SIMI VALLEY
Practice Address - State:CA
Practice Address - Zip Code:93065
Practice Address - Country:US
Practice Address - Phone:805-428-9246
Practice Address - Fax:805-915-0422
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-13
Last Update Date:2011-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)