Provider Demographics
NPI:1104905199
Name:WESTERN PULMONARY MEDICAL GROUP INC
Entity type:Organization
Organization Name:WESTERN PULMONARY MEDICAL GROUP INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:L
Authorized Official - Last Name:PEARLE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:714-446-8702
Mailing Address - Street 1:19742 MACARTHUR BLVD STE 100
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92612-2408
Mailing Address - Country:US
Mailing Address - Phone:949-428-0330
Mailing Address - Fax:714-879-1049
Practice Address - Street 1:19742 MACARTHUR BLVD STE 100
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92612-2408
Practice Address - Country:US
Practice Address - Phone:949-428-0330
Practice Address - Fax:714-879-1049
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-02
Last Update Date:2023-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Multi-Specialty
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care MedicineGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ97067ZOtherBLUE SHIELD
CA199372700OtherDEPT OF LABOR PROV NUMBER
CAGR0014371OtherMEDI-CAL GRP PRV NUMBER
CA1982783940OtherDR PEARLE NPI
CA1346329323OtherDR MCNABB NPI
CAGR0014371OtherMEDI-CAL GRP PRV NUMBER
CAZZZ97067ZOtherBLUE SHIELD
CA1043399017OtherDR HARDEMAN NPI
CA1174602163OtherDR SAYYUR NPI