Basic Information
Provider Information
NPI: 1194995522
EntityType: 2
ReplacementNPI:  
OrganizationName: PAUL K GILBERT MD APC
LastName:  
FirstName:  
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 39 CONGRESS ST
Address2: SUITE 301
City: PASADENA
State: CA
PostalCode: 911053024
CountryCode: US
TelephoneNumber: 6264860187
FaxNumber: 6264860189
Practice Location
Address1: 39 CONGRESS ST
Address2: SUITE 301
City: PASADENA
State: CA
PostalCode: 911053024
CountryCode: US
TelephoneNumber: 6264860187
FaxNumber: 6264860189
Other Information
ProviderEnumerationDate: 02/29/2008
LastUpdateDate: 02/29/2008
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: GILBERT
AuthorizedOfficialFirstName: PAUL
AuthorizedOfficialMiddleName: KEITH
AuthorizedOfficialTitleorPosition: M.D.
AuthorizedOfficialTelephone: 6264860187
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix: DR.
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential: M.D.
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
332B00000XG54181CAY SuppliersDurable Medical Equipment & Medical Supplies 

No ID Information.


Home