Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Mr. Mark Raymond Perreault, PA-C

Individual provider Physician Assistant · NPI 1356749451

Mr. Mark Raymond Perreault, PA-C is a Physician Assistant in San Diego, California. Qualified in 2014, 12 years ago. Practices with Regents of the University of California, a 2,061-clinician group and accepts Medicare assignment. Licensed in California and Connecticut.

Years since qualifying
12
Licensed in
CA, CT
In the registry since
2014
Specialties on file
4
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

200 W Arbor Dr
San Diego, CA 92103-9000
Phone: (800) 926-8273
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Surgical Physician Assistant (primary) Taxonomy 363AS0400X · Licence PA57736 (CA)
Physician Assistant Taxonomy 363A00000X · Licence 003332 (CT)
Medical Physician Assistant Taxonomy 363AM0700X · Licence 003332 (CT)
Surgical Physician Assistant Taxonomy 363AS0400X · Licence 003332 (CT)

Record details

NPI number1356749451
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorNo
NPI enumeratedDecember 5, 2014
Last updated in NPPESJuly 20, 2021
Certification dateJuly 20, 2021

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2014 (12 years in practice)
Group practice Regents Of The University Of California — 2061 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

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