Provider Demographics
NPI:1881741056
Name:PEARSON, CHRISTOPHER WT (MD)
Entity type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:WT
Last Name:PEARSON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1411 W OLIVE AVE
Mailing Address - Street 2:SUITE D & E
Mailing Address - City:BURBANK
Mailing Address - State:CA
Mailing Address - Zip Code:91506-2427
Mailing Address - Country:US
Mailing Address - Phone:818-843-1884
Mailing Address - Fax:818-843-4622
Practice Address - Street 1:1411 W OLIVE AVE
Practice Address - Street 2:SUITE D & E
Practice Address - City:BURBANK
Practice Address - State:CA
Practice Address - Zip Code:91506-2427
Practice Address - Country:US
Practice Address - Phone:818-843-1884
Practice Address - Fax:818-843-4622
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA32552207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA84364Medicare UPIN