Basic Information
| Provider Information | |||||||||
| NPI: | 1134214851 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | PEARLSTEIN | ||||||||
| FirstName: | RICHARD | ||||||||
| MiddleName: | P | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1010 E MCDOWELL RD STE 206 | ||||||||
| Address2: | |||||||||
| City: | PHOENIX | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 850062608 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6029561250 | ||||||||
| FaxNumber: | 6233218620 | ||||||||
| Practice Location | |||||||||
| Address1: | 1010 E MCDOWELL RD STE 200 | ||||||||
| Address2: | |||||||||
| City: | PHOENIX | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 850062608 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6029561250 | ||||||||
| FaxNumber: | 6233218620 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/04/2006 | ||||||||
| LastUpdateDate: | 03/03/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 03/03/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Y00000X | 35.065682 | OH | N | Allopathic & Osteopathic Physicians | Otolaryngology | 207Y00000X | 57919 | AZ | Y | Allopathic & Osteopathic Physicians | Otolaryngology |
ID Information
| ID | Type | State | Issuer | Description | 341112079028 | 01 | CARESOURCE | OTHER | 040012377 | 01 | MEDICARE RAILROAD | OTHER | 1546564 | 01 | GATEWAY | OTHER | 000000127502 | 01 | OH | ANTHEM | OTHER | 3270308001 | 01 | OH | CIGNA | OTHER | Z65682 | 01 | SUMMACARE | OTHER | 000000127502 | 01 | UNICARE | OTHER | 588765 | 05 | AZ | MEDICAID | 112089 | 01 | UNISON | OTHER | 2049161 | 05 | OH | MEDICAID | 099857 | 01 | SELECT BLUE | OTHER | 10-00511 | 01 | OH | UHC | OTHER |