Provider Demographics
NPI:1518128891
Name:PEARSON, MARY MARGARET (MD)
Entity Type:Individual
Prefix:DR
First Name:MARY
Middle Name:MARGARET
Last Name:PEARSON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 743749
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90074-3749
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1001 POTRERO AVE BUILDING 5 1ST FLOOR, #1E
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94110-3518
Practice Address - Country:US
Practice Address - Phone:628-206-8446
Practice Address - Fax:628-206-8387
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-19
Last Update Date:2023-01-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA104494207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine