Basic Information
Provider Information
NPI: 1366519258
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: PEARLMAN
FirstName: PAULA
MiddleName: J.
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: GLOSSERMAN
OtherFirstName: PAULA
OtherMiddleName: J.
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential: MD
OtherLastNameType: 5
Mailing Information
Address1: 6041 CADILLAC AVE
Address2:  
City: LOS ANGELES
State: CA
PostalCode: 900341702
CountryCode: US
TelephoneNumber: 3238572000
FaxNumber:  
Practice Location
Address1: 6041 CADILLAC AVE
Address2:  
City: LOS ANGELES
State: CA
PostalCode: 900341702
CountryCode: US
TelephoneNumber: 3238572000
FaxNumber: 3238572005
Other Information
ProviderEnumerationDate: 11/29/2006
LastUpdateDate: 05/26/2010
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207P00000XG48501CAY Allopathic & Osteopathic PhysiciansEmergency Medicine 

No ID Information.


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