Provider Demographics
NPI:1811909708
Name:MOHABIR, PAUL K (MD)
Entity type:Individual
Prefix:DR
First Name:PAUL
Middle Name:K
Last Name:MOHABIR
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:STANFORD UNIVERSITY SCHOOL OF MEDICINE
Mailing Address - Street 2:300 PASTEUR DR, H3143
Mailing Address - City:STANFORD
Mailing Address - State:CA
Mailing Address - Zip Code:94305-5236
Mailing Address - Country:US
Mailing Address - Phone:650-723-6381
Mailing Address - Fax:
Practice Address - Street 1:STANFORD UNIVERSITY SCHOOL OF MEDICINE
Practice Address - Street 2:300 PASTEUR DR, H3143
Practice Address - City:STANFORD
Practice Address - State:CA
Practice Address - Zip Code:94305-5236
Practice Address - Country:US
Practice Address - Phone:650-723-6381
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-12
Last Update Date:2019-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA81363207RC0200X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A813630Medicaid
CAH81855Medicare UPIN
CA00A813630Medicaid