Provider Demographics
NPI:1528951126
Name:PERRY, DAVID LEONARD JR
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:LEONARD
Last Name:PERRY
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:440 E HUNTINGTON DR STE 300
Mailing Address - Street 2:
Mailing Address - City:ARCADIA
Mailing Address - State:CA
Mailing Address - Zip Code:91006-3775
Mailing Address - Country:US
Mailing Address - Phone:626-413-8317
Mailing Address - Fax:
Practice Address - Street 1:921 MOUNT OLIVE DR APT 1
Practice Address - Street 2:
Practice Address - City:DUARTE
Practice Address - State:CA
Practice Address - Zip Code:91010-2173
Practice Address - Country:US
Practice Address - Phone:310-692-3475
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-02
Last Update Date:2025-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171W00000XOther Service ProvidersContractorGroup - Single Specialty