Provider Demographics
NPI:1487440533
Name:PEREZ, ELIEZER
Entity type:Individual
Prefix:
First Name:ELIEZER
Middle Name:
Last Name:PEREZ
Suffix:
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 1:3959 RUFFIN RD STE J
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92123-1830
Mailing Address - Country:US
Mailing Address - Phone:858-279-5570
Mailing Address - Fax:858-279-5570
Practice Address - Street 1:335 E PENNSYLVANIA AVE
Practice Address - Street 2:
Practice Address - City:ESCONDIDO
Practice Address - State:CA
Practice Address - Zip Code:92025-2810
Practice Address - Country:US
Practice Address - Phone:760-294-6100
Practice Address - Fax:760-294-6101
Is Sole Proprietor?:No
Enumeration Date:2025-04-16
Last Update Date:2025-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist