Provider Demographics
NPI:1396599239
Name:AUDON, PEARL (DO)
Entity type:Individual
Prefix:
First Name:PEARL
Middle Name:
Last Name:AUDON
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 THE CITY DR S FL 3
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92868-3201
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:101 THE CITY DRIVE SOUTH, DOUGLAS HOSPITAL, 3RD FLOOR
Practice Address - Street 2:ROOM 3003
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92868
Practice Address - Country:US
Practice Address - Phone:714-456-6411
Practice Address - Fax:714-456-5149
Is Sole Proprietor?:No
Enumeration Date:2024-04-16
Last Update Date:2024-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program