Healthcare Provider Details

I. General information

NPI: 1326057746
Provider Name (Legal Business Name): BARRY J PEARLMAN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/05/2006
Last Update Date: 03/03/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

150 N ROBERTSON BLVD SUITE 204
BEVERLY HILLS CA
90211-2142
US

IV. Provider business mailing address

150 N ROBERTSON BLVD SUITE 204
BEVERLY HILLS CA
90211-2142
US

V. Phone/Fax

Practice location:
  • Phone: 310-279-4644
  • Fax: 310-659-4300
Mailing address:
  • Phone: 310-279-4644
  • Fax: 310-659-4300

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License NumberA90815
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: