Provider Demographics
NPI:1902173636
Name:PEARLMAN, STEPHEN N (BSPHARMACY)
Entity Type:Individual
Prefix:
First Name:STEPHEN
Middle Name:N
Last Name:PEARLMAN
Suffix:
Gender:M
Credentials:BSPHARMACY
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:336 MULLET CT
Mailing Address - Street 2:
Mailing Address - City:FOSTER CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94404-1935
Mailing Address - Country:US
Mailing Address - Phone:650-341-7928
Mailing Address - Fax:650-341-8663
Practice Address - Street 1:1100 EL CAMINO REAL
Practice Address - Street 2:
Practice Address - City:BELMONT
Practice Address - State:CA
Practice Address - Zip Code:94002-3904
Practice Address - Country:US
Practice Address - Phone:650-596-1735
Practice Address - Fax:650-596-1738
Is Sole Proprietor?:No
Enumeration Date:2011-11-23
Last Update Date:2011-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA22523183500000X
IDP3254183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist