Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Y00000X | Otolaryngologist (ENT Doctor) | 239098 | NY |
N | 207Y00000X | Otolaryngologist (ENT Doctor) | A108195 | CA |
Y | 207YS0123X | Facial Plastic Surgeon | A108195 | CA |
NPI | 1922158526 |
---|---|
Provider Name | James Pearson |
First Address | Hermosa Beach, CA 90254-2734 |
Second Address | Hermosa Beach, CA 90254-2447 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/01/2007 |
Last Update Date | 27/06/2016 |