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General NPI Number Information
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NPI Number | 1558944637
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Entity Type | Organization
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Legal Business Name | PEARL FAMILY MEDICINE PC
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Dates
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Enumeration Date | 05/05/2021
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Last Update Date | 05/12/2022
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Provider Practice Location Address
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Address Line | 1445 S PEARL ST
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City | DENVER
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State | CO
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Zip | 80210-2226
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Country | US
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Telephone | 720-244-6993
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Fax |
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Provider Business Mailing Address
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Address Line | 1445 S PEARL ST
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City | DENVER
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State | CO
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Zip | 80210-2226
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Country | US
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Telephone | 303-600-3699
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Fax | 833-731-0601
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Authorized Official
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Title or Position | OWNER
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Name | LISA ROTHGERY
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Credential | MD
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Telephone | 303-600-3699
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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