Basic Information
| Provider Information | |||||||||
| NPI: | 1376000463 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | LOBAUGH | ||||||||
| FirstName: | PAUL | ||||||||
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| Credential: | PHD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 6425 LIVING PLACE | ||||||||
| Address2: | SECOND FLOOR | ||||||||
| City: | PITTSBURGH | ||||||||
| State: | PA | ||||||||
| PostalCode: | 15238 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4127841930 | ||||||||
| FaxNumber: | 4129689113 | ||||||||
| Practice Location | |||||||||
| Address1: | ASTIA SUNNYSIDE HOSPITAL | ||||||||
| Address2: | 1016 TACOMA AVENUE | ||||||||
| City: | SUNNYSIDE | ||||||||
| State: | WA | ||||||||
| PostalCode: | 98944 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5098371500 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 02/25/2019 | ||||||||
| LastUpdateDate: | 02/25/2019 | ||||||||
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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 | 246ZE0500X | Y | Technologists, Technicians & Other Technical Service Providers | Specialist/Technologist, Other | EEG |
No ID Information.