Basic Information
| Provider Information | |||||||||
| NPI: | 1679739510 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | PAUL C NORWOOD MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 27396 | ||||||||
| Address2: | |||||||||
| City: | FRESNO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 937297396 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5594381245 | ||||||||
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| Practice Location | |||||||||
| Address1: | 550 E HERNDON AVE | ||||||||
| Address2: | SUITE 101 | ||||||||
| City: | FRESNO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 937202992 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5594381245 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/30/2008 | ||||||||
| LastUpdateDate: | 07/31/2008 | ||||||||
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| AuthorizedOfficialLastName: | NORWOOD | ||||||||
| AuthorizedOfficialFirstName: | PAUL | ||||||||
| AuthorizedOfficialMiddleName: | C | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 5594381245 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RE0101X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | Endocrinology, Diabetes & Metabolism |
ID Information
| ID | Type | State | Issuer | Description | 110015585 | 01 | CA | RAILROAD MEDICARE | OTHER |