Provider Demographics
NPI:1962729251
Name:PEREZ, MERYL ANN (MD)
Entity type:Individual
Prefix:
First Name:MERYL
Middle Name:ANN
Last Name:PEREZ
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:1300 ETHAN WAY STE 600
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95825-2296
Mailing Address - Country:US
Mailing Address - Phone:916-679-3513
Mailing Address - Fax:916-679-3563
Practice Address - Street 1:5 MEDICAL PLAZA DR STE 190
Practice Address - Street 2:
Practice Address - City:ROSEVILLE
Practice Address - State:CA
Practice Address - Zip Code:95661-2867
Practice Address - Country:US
Practice Address - Phone:916-679-3590
Practice Address - Fax:916-679-3563
Is Sole Proprietor?:No
Enumeration Date:2010-04-26
Last Update Date:2019-10-10
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Provider Licenses
StateLicense IDTaxonomies
CAA123918207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA123918OtherCALIFORNIA MEDICAL LICENSE