Basic Information
| Provider Information | |||||||||
| NPI: | 1598756942 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | PEARSON | ||||||||
| FirstName: | JAMES | ||||||||
| MiddleName: | RICHARD | ||||||||
| NamePrefix: | MR. | ||||||||
| NameSuffix: | JR. | ||||||||
| Credential: | PAC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 155 SOLANO ST | ||||||||
| Address2: | CORNING MEDICAL ASSOCIATES INC | ||||||||
| City: | CORNING | ||||||||
| State: | CA | ||||||||
| PostalCode: | 960213511 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5308244663 | ||||||||
| FaxNumber: | 5308245204 | ||||||||
| Practice Location | |||||||||
| Address1: | 155 SOLANO ST | ||||||||
| Address2: | CORNING MEDICAL ASSOCIATES INC | ||||||||
| City: | CORNING | ||||||||
| State: | CA | ||||||||
| PostalCode: | 960213511 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5308244663 | ||||||||
| FaxNumber: | 5308245204 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/03/2005 | ||||||||
| LastUpdateDate: | 05/12/2011 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363AM0700X | PA12619 | CA | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | Medical |
No ID Information.