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Individual

BRIAN THOMAS PEARSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
6302 13TH AVE, LUCERNE, CA 95458
(707) 274-1901
Mailing address
PO BOX 1024, LUCERNE, CA 95458-1024
(707) 274-1901

Taxonomy

Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
946000825
CA
Enumeration date
10/26/2017
Last updated
10/26/2017
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