Healthcare Provider Details

I. General information

NPI: 1902173636
Provider Name (Legal Business Name): STEPHEN N PEARLMAN BSPHARMACY
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/23/2011
Last Update Date: 11/23/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1100 EL CAMINO REAL
BELMONT CA
94002-3904
US

IV. Provider business mailing address

336 MULLET CT
FOSTER CITY CA
94404-1935
US

V. Phone/Fax

Practice location:
  • Phone: 650-596-1735
  • Fax: 650-596-1738
Mailing address:
  • Phone: 650-341-7928
  • Fax: 650-341-8663

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number22523
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberP3254
License Number StateID

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: