Mark D Perrault | Culver City, CA • PECOS Search

Mark D Perrault

Psychiatry & Neurology

Allopathic & Osteopathic Physicians

11111 Jefferson Blvd, 5005, Culver City, CA 90230-6903

PECOS Enrollment

Based on the most recent information from CMS, provider Mark D Perrault does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records 34 days ago.

Profile Details

Provider ID
1649506643
Provider Type
Individual
Full Name
Perrault, Mark D
Credential
M.D.

Gender
Male
Sole Proprietor
Yes
Enumeration Date
10/26/2009
Last Updated
1/11/2022

Contact Information

Practice Location

11111 Jefferson Blvd, 5005, Culver City, CA 90230-6903

(310) 733-1835

Mailing Location

3940 Olmsted Ave, Los Angeles, CA 90008-2626

(310) 733-1835

Provider Taxonomies

Code	Description	License
Code 2084P0800X Primary	Description Psychiatry & Neurology Allopathic & Osteopathic Physicians	License A43550 California