Provider Demographics
NPI:1538234190
Name:PEARSON, LAWRENCE FRANKLIN (MD)
Entity type:Individual
Prefix:DR
First Name:LAWRENCE
Middle Name:FRANKLIN
Last Name:PEARSON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:113 S VINE ST
Mailing Address - Street 2:SUITE A
Mailing Address - City:FALLBROOK
Mailing Address - State:CA
Mailing Address - Zip Code:92028-2925
Mailing Address - Country:US
Mailing Address - Phone:760-723-2313
Mailing Address - Fax:760-723-0333
Practice Address - Street 1:113 S VINE ST
Practice Address - Street 2:SUITE A
Practice Address - City:FALLBROOK
Practice Address - State:CA
Practice Address - Zip Code:92028-2925
Practice Address - Country:US
Practice Address - Phone:760-723-2313
Practice Address - Fax:760-723-0333
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-21
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG374120207V00000X
CAG37412207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG37412OtherLIC NUMBER
CA1730502253OtherNPI
CA00G374120Medicaid
CA00G374120Medicaid
CAG37412OtherLIC NUMBER