NPIMap

Organization Active NPI

Pearl Group Medical Professional Corporation

  • Interventional Pain Medicine Physician
  • Desert Hot Springs, CA
National Provider Identifier
1053647206
Registry record updated Dec 9, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X
License
CI961B Issued in CA
Legal business name
PEARL GROUP MEDICAL PROFESSIONAL CORPORATION
Practice address
10625 Palm Dr
Desert Hot Springs, CA 92240-2534
Phone
(310) 312-1111
Fax
(310) 312-1139
NPI assigned
Oct 22, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 9, 2009

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Alice Meyler, M.D.
Title
Medical Director
Phone
(310) 312-1111

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Interventional Pain Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208VP0014X CI961B CA Primary

Addresses

Primary practice location

10625 Palm Dr
Desert Hot Springs, CA 92240-2534

Mailing address

11860 Wilshire Blvd
Ste 100
Los Angeles, CA 90025-6613
Phone (310) 312-1111

National Provider Directory

National Provider Directory

Locations

11860 Wilshire Blvd
Ste 100
Los Angeles, CA 90025
Phone (310) 312-1111

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1256169600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1260316800000",
    "number": "1053647206",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11860 WILSHIRE BLVD",
            "address_2": "STE 100",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900256613",
            "telephone_number": "310-312-1111",
            "fax_number": "310-312-1139"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10625 PALM DR",
            "city": "DESERT HOT SPRINGS",
            "state": "CA",
            "postal_code": "922402534",
            "telephone_number": "310-312-1111",
            "fax_number": "310-312-1139"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEARL GROUP MEDICAL PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-10-22",
        "last_updated": "2009-12-09",
        "status": "A",
        "authorized_official_last_name": "MEYLER",
        "authorized_official_first_name": "ALICE",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "310-312-1111",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208VP0014X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "CA",
            "license": "CI961B",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Desert Hot Springs, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.