Provider Demographics
NPI:1699767848
Name:GENSTLER, PAULALAN E (MD)
Entity type:Individual
Prefix:DR
First Name:PAULALAN
Middle Name:E
Last Name:GENSTLER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:555 AGUAJITO RD
Mailing Address - Street 2:
Mailing Address - City:CARMEL
Mailing Address - State:CA
Mailing Address - Zip Code:93923-9464
Mailing Address - Country:US
Mailing Address - Phone:831-644-9293
Mailing Address - Fax:
Practice Address - Street 1:555 AGUAJITO RD
Practice Address - Street 2:
Practice Address - City:CARMEL
Practice Address - State:CA
Practice Address - Zip Code:93923-9464
Practice Address - Country:US
Practice Address - Phone:831-644-9293
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-08-15
Last Update Date:2010-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG031346207P00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA44733Medicare UPIN
CAAP770XMedicare PIN