Provider Demographics
NPI:1427052257
Name:SOBELMAN, PAUL BERNARD (MD)
Entity type:Individual
Prefix:DR
First Name:PAUL
Middle Name:BERNARD
Last Name:SOBELMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1212 GOLD STRIKE DR
Mailing Address - Street 2:
Mailing Address - City:PLACERVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95667-9426
Mailing Address - Country:US
Mailing Address - Phone:530-622-8183
Mailing Address - Fax:
Practice Address - Street 1:1000 FOWLER WAY
Practice Address - Street 2:STE 7
Practice Address - City:PLACERVILLE
Practice Address - State:CA
Practice Address - Zip Code:95667-5738
Practice Address - Country:US
Practice Address - Phone:530-295-0608
Practice Address - Fax:530-295-0328
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-09
Last Update Date:2008-09-25
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAG039274207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA080151839OtherRAILROAD MEDICARE
CAB34466Medicare UPIN