Basic Information
| Provider Information | |||||||||
| NPI: | 1316123573 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | PAUL K GILBERT MD APC | ||||||||
| LastName: | |||||||||
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| OtherOrganizationName: | PAUL K GILBERT MD APC | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 50148 | ||||||||
| Address2: | |||||||||
| City: | PASADENA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 911150148 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6264860187 | ||||||||
| FaxNumber: | 6264860189 | ||||||||
| Practice Location | |||||||||
| Address1: | 39 CONGRESS ST | ||||||||
| Address2: | SUITE 201 | ||||||||
| City: | PASADENA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 911053024 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6264860187 | ||||||||
| FaxNumber: | 6264860189 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/17/2008 | ||||||||
| LastUpdateDate: | 08/05/2009 | ||||||||
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| ProviderGenderCode: | |||||||||
| AuthorizedOfficialLastName: | GILBERT | ||||||||
| AuthorizedOfficialFirstName: | PAUL | ||||||||
| AuthorizedOfficialMiddleName: | K | ||||||||
| AuthorizedOfficialTitleorPosition: | MEDICAL DOCTOR | ||||||||
| AuthorizedOfficialTelephone: | 6264860187 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
| ParentOrganizationLBN: | |||||||||
| AuthorizedOfficialNamePrefix: | DR. | ||||||||
| AuthorizedOfficialNameSuffix: | |||||||||
| AuthorizedOfficialCredential: | MD | ||||||||
| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QH0100X | G54181 | CA | Y | Ambulatory Health Care Facilities | Clinic/Center | Health Service |
No ID Information.