Provider Demographics
NPI:1730502253
Name:LAWRENCE F. PEARSON, M.D.
Entity Type:Organization
Organization Name:LAWRENCE F. PEARSON, M.D.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LAWRENCE
Authorized Official - Middle Name:F
Authorized Official - Last Name:PEARSON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:760-723-2313
Mailing Address - Street 1:113 S VINE ST
Mailing Address - Street 2:SUITE A
Mailing Address - City:FALLBROOK
Mailing Address - State:CA
Mailing Address - Zip Code:92028-2925
Mailing Address - Country:US
Mailing Address - Phone:760-723-2313
Mailing Address - Fax:760-723-0333
Practice Address - Street 1:113 S VINE ST
Practice Address - Street 2:SUITE A
Practice Address - City:FALLBROOK
Practice Address - State:CA
Practice Address - Zip Code:92028-2925
Practice Address - Country:US
Practice Address - Phone:760-723-2313
Practice Address - Fax:760-723-0333
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-04
Last Update Date:2014-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG37412207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G374120Medicaid
CA00G374120Medicaid