Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207R00000X | Internist | A46379 | CA |
Y | 111NI0900X | Internist | A46379 | CA |
N | 207RG0300X | Geriatric Medicine | A46379 | CA |
NPI | 1134232473 |
---|---|
Provider Name | Jacqueline Paul |
First Address | Bakersfield, CA 93302-1559 |
Second Address | Bakersfield, CA 93307-1365 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/08/2006 |
Last Update Date | 18/01/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
F10884 | (02) |