MEDICARE: DR. SAMUEL NELSON PEARL M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208200000X	Plastic Surgery Physician	G32158	CA

General Provider Information

NPI Number	:	1487722393
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SAMUEL NELSON PEARL M.D.

Provider Business Mailing Address
First Line	:	525 SOUTH DR STE 203
Second Line	:
City	:	MOUNTAIN VIEW
State	:	CA
Zip	:	94040-4211
Country	:	US
Telephone Number	:	650-964-6600
Fax Number	:	650-964-7389

Provider Business Practice Location Address
First Line	:	525 SOUTH DR STE 203
Second Line	:
City	:	MOUNTAIN VIEW
State	:	CA
Zip	:	94040-4211
Country	:	US
Telephone Number	:	650-964-6600
Fax Number	:	650-964-7639

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/30/2006
Last Update Date	:	07/08/2007

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