Provider Demographics
NPI:1972811412
Name:PAUL, ROBERT (PA)
Entity type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:
Last Name:PAUL
Suffix:
Gender:M
Credentials:PA
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Mailing Address - Street 1:10565 CIVIC CENTER DR STE 250
Mailing Address - Street 2:
Mailing Address - City:RANCHO CUCAMONGA
Mailing Address - State:CA
Mailing Address - Zip Code:91730-3854
Mailing Address - Country:US
Mailing Address - Phone:626-696-1400
Mailing Address - Fax:626-696-1451
Practice Address - Street 1:340 FOURTH AVE STE 19
Practice Address - Street 2:
Practice Address - City:CHULA VISTA
Practice Address - State:CA
Practice Address - Zip Code:91910-3898
Practice Address - Country:US
Practice Address - Phone:619-761-5308
Practice Address - Fax:619-591-1910
Is Sole Proprietor?:No
Enumeration Date:2010-09-17
Last Update Date:2025-02-07
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Provider Licenses
StateLicense IDTaxonomies
CA22368363A00000X
363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant