Provider Demographics
NPI:1194995522
Name:PAUL K GILBERT MD APC
Entity type:Organization
Organization Name:PAUL K GILBERT MD APC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:M.D.
Authorized Official - Prefix:DR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:KEITH
Authorized Official - Last Name:GILBERT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:626-486-0187
Mailing Address - Street 1:39 CONGRESS ST
Mailing Address - Street 2:SUITE 301
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91105-3024
Mailing Address - Country:US
Mailing Address - Phone:626-486-0187
Mailing Address - Fax:626-486-0189
Practice Address - Street 1:39 CONGRESS ST
Practice Address - Street 2:SUITE 301
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91105-3024
Practice Address - Country:US
Practice Address - Phone:626-486-0187
Practice Address - Fax:626-486-0189
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-29
Last Update Date:2008-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG54181332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAE59428Medicare UPIN
CAG54181Medicare PIN