Provider Demographics
NPI:1669341897
Name:PEREZ-LANDEROS, MICHELL
Entity type:Individual
Prefix:
First Name:MICHELL
Middle Name:
Last Name:PEREZ-LANDEROS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2805
Mailing Address - Street 2:
Mailing Address - City:INDIO
Mailing Address - State:CA
Mailing Address - Zip Code:92202-3505
Mailing Address - Country:US
Mailing Address - Phone:442-300-1479
Mailing Address - Fax:
Practice Address - Street 1:746 N E ST
Practice Address - Street 2:
Practice Address - City:SAN BERNARDINO
Practice Address - State:CA
Practice Address - Zip Code:92410-3047
Practice Address - Country:US
Practice Address - Phone:909-381-1100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-11-04
Last Update Date:2025-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program