Provider Demographics
NPI:1215943444
Name:PERRI, BRIAN REGIS (DO)
Entity type:Individual
Prefix:
First Name:BRIAN
Middle Name:REGIS
Last Name:PERRI
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8436 WEST THIRD STREET
Mailing Address - Street 2:SUITE 900
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90048
Mailing Address - Country:US
Mailing Address - Phone:310-746-5918
Mailing Address - Fax:323-433-7016
Practice Address - Street 1:8436 WEST THIRD STREET
Practice Address - Street 2:SUITE 900
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90048
Practice Address - Country:US
Practice Address - Phone:310-746-5918
Practice Address - Fax:323-433-7016
Is Sole Proprietor?:No
Enumeration Date:2006-07-31
Last Update Date:2016-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A8714204C00000X, 207XS0117X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0117XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the Spine
No204C00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine, Sports Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAW20A8714BMedicare PIN
CAW20A8714CMedicare PIN