MEDICARE: JAMES PEARSON M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Y00000X	Otolaryngology Physician	239098	NY
2	207Y00000X	Otolaryngology Physician	A108195	CA
3	207YS0123X	Facial Plastic Surgery Physician	A108195	CA

General Provider Information

NPI Number	:	1922158526
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAMES PEARSON M.D.

Provider Business Mailing Address
First Line	:	2401 PACIFIC COAST HWY
Second Line	:	STE 105
City	:	HERMOSA BEACH
State	:	CA
Zip	:	90254-2734
Country	:	US
Telephone Number	:	310-494-6430
Fax Number	:	424-247-5072

Provider Business Practice Location Address
First Line	:	2629 MANHATTAN AVE
Second Line	:	PMB 265
City	:	HERMOSA BEACH
State	:	CA
Zip	:	90254-2447
Country	:	US
Telephone Number	:	310-494-6430
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/12/2007
Last Update Date	:	06/27/2016

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