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Organization

JEFFREY K PEARSON A PROFESSIONAL MEDICAL CORPORATION

Active
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Organization

JEFFREY K PEARSON A PROFESSIONAL MEDICAL CORPORATION

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. JEFFREY K PEARSON D.O. (PRESIDENT/OWNER)
(760) 591-0955
Entity
Organization

Contact information

Practice address
120 CRAVEN RD, SUITE 101, SAN MARCOS, CA 92078-4235
(760) 591-0955
(760) 591-3680
Mailing address
120 CRAVEN RD, SUITE 101, SAN MARCOS, CA 92078-4235
(760) 591-0955
(760) 591-3680

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
20A5534
CA
207R00000X
Internal Medicine Physician
A45444
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
—
20A5534
MEDICAL LICENSE
CA
01
—
BY503Y
MEDICARE PTAN
CA
Enumeration date
06/19/2009
Last updated
07/18/2012
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