Healthcare Provider Details

I. General information

NPI: 1164476602
Provider Name (Legal Business Name): JULES PEAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/20/2006
Last Update Date: 06/05/2026
Certification Date: 06/05/2026
Deactivation Date: 09/10/2025
Reactivation Date: 10/06/2025

III. Provider practice location address

1707 W SAINT MARYS RD STE 101
TUCSON AZ
85745-2612
US

IV. Provider business mailing address

100 GREENLEY RD
SONORA CA
95370-5936
US

V. Phone/Fax

Practice location:
  • Phone: 520-622-5912
  • Fax:
Mailing address:
  • Phone: 210-271-3204
  • Fax: 210-222-2761

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberC51988
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberQ1882
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: