Individual
SHANNON PEARSALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2463 IRVINE AVE APT D1, COSTA MESA, CA 92627-5403
(194) 950-0915
(949) 500-9156
Mailing address
2463 IRVINE AVE APT D1, COSTA MESA, CA 92627-5403
(194) 500-9156
Taxonomy
Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
—
—
Other
Enumeration date
10/27/2017
Last updated
10/27/2017
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