Provider Demographics
NPI:1235248022
Name:JEFFREY PEARSON, D.O
Entity Type:Organization
Organization Name:JEFFREY PEARSON, D.O
Other - Org Name:MEDICINE IN MOTION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:ELAINE
Authorized Official - Middle Name:G
Authorized Official - Last Name:PEARSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:760-591-0955
Mailing Address - Street 1:120 CRAVEN RD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:SAN MARCOS
Mailing Address - State:CA
Mailing Address - Zip Code:92078-4235
Mailing Address - Country:US
Mailing Address - Phone:760-591-0955
Mailing Address - Fax:760-591-3680
Practice Address - Street 1:120 CRAVEN RD
Practice Address - Street 2:SUITE 101
Practice Address - City:SAN MARCOS
Practice Address - State:CA
Practice Address - Zip Code:92078-4235
Practice Address - Country:US
Practice Address - Phone:760-591-0955
Practice Address - Fax:760-591-3680
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAC54095Medicare UPIN