Provider Demographics
NPI:1922897255
Name:PEREZ, SEAN CARLO
Entity type:Individual
Prefix:
First Name:SEAN
Middle Name:CARLO
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 1:2149 W NORFOLK CIR
Mailing Address - Street 2:
Mailing Address - City:HANFORD
Mailing Address - State:CA
Mailing Address - Zip Code:93230-9185
Mailing Address - Country:US
Mailing Address - Phone:559-698-4061
Mailing Address - Fax:
Practice Address - Street 1:2149 W NORFOLK CIR
Practice Address - Street 2:
Practice Address - City:HANFORD
Practice Address - State:CA
Practice Address - Zip Code:93230-9185
Practice Address - Country:US
Practice Address - Phone:559-698-4061
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-02
Last Update Date:2025-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant