Healthcare Provider Details

I. General information

NPI: 1134214851
Provider Name (Legal Business Name): RICHARD P PEARLSTEIN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/04/2006
Last Update Date: 03/03/2022
Certification Date: 03/03/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1010 E MCDOWELL RD STE 200
PHOENIX AZ
85006-2608
US

IV. Provider business mailing address

1010 E MCDOWELL RD STE 206
PHOENIX AZ
85006-2608
US

V. Phone/Fax

Practice location:
  • Phone: 602-956-1250
  • Fax: 623-321-8620
Mailing address:
  • Phone: 602-956-1250
  • Fax: 623-321-8620

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number35.065682
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number57919
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: