Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207L00000X | Anesthesiologist | G38269 | CA |
N | 207R00000X | Internist | G38269 | CA |
N | 111NI0900X | Internist | G38269 | CA |
NPI | 1003958240 |
---|---|
Provider Name | Dr. Ronald Gary Pearl |
First Address | Palo Alto, CA 94306-2727 |
Second Address | Stanford, CA 94305-2200 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/02/2007 |
Last Update Date | 06/01/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00G382690 | (05) | CA |
A47418 | (02) | CA |