Provider Demographics
NPI:1699775502
Name:PERRIN, PETER (RPH)
Entity type:Individual
Prefix:MR
First Name:PETER
Middle Name:
Last Name:PERRIN
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3051 FUJITA ST
Mailing Address - Street 2:
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90505-4004
Mailing Address - Country:US
Mailing Address - Phone:310-326-5656
Mailing Address - Fax:
Practice Address - Street 1:3051 FUJITA ST
Practice Address - Street 2:
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90505-4004
Practice Address - Country:US
Practice Address - Phone:310-326-5656
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-07-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA248131835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA24813OtherSTATE PHARMACIST LICENSE