Provider Demographics
NPI:1699962431
Name:FRANCISCO PERAZA MD PC
Entity type:Organization
Organization Name:FRANCISCO PERAZA MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:FRANCISCO
Authorized Official - Middle Name:
Authorized Official - Last Name:PERAZA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:702-732-7440
Mailing Address - Street 1:PO BOX 26568
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89126-0568
Mailing Address - Country:US
Mailing Address - Phone:702-732-7440
Mailing Address - Fax:702-732-9672
Practice Address - Street 1:5781 W SAHARA AVE STE 500
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89146-3168
Practice Address - Country:US
Practice Address - Phone:702-331-1700
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-25
Last Update Date:2012-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedicalGroup - Multi-Specialty
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVV104819Medicare PIN