Provider Demographics
NPI:1134214851
Name:PEARLSTEIN, RICHARD P (MD)
Entity type:Individual
Prefix:
First Name:RICHARD
Middle Name:P
Last Name:PEARLSTEIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1010 E MCDOWELL RD STE 206
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85006-2608
Mailing Address - Country:US
Mailing Address - Phone:602-956-1250
Mailing Address - Fax:623-321-8620
Practice Address - Street 1:1010 E MCDOWELL RD STE 200
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85006-2608
Practice Address - Country:US
Practice Address - Phone:602-956-1250
Practice Address - Fax:623-321-8620
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2022-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.065682207Y00000X
AZ57919207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
341112079028OtherCARESOURCE
040012377OtherMEDICARE RAILROAD
1546564OtherGATEWAY
OH000000127502OtherANTHEM
OH3270308001OtherCIGNA
Z65682OtherSUMMACARE
000000127502OtherUNICARE
AZ588765Medicaid
112089OtherUNISON
OH2049161Medicaid
099857OtherSELECT BLUE
OH10-00511OtherUHC
1546564OtherGATEWAY
341112079028OtherCARESOURCE