Healthcare Provider Details
I. General information
NPI: 1801961727
Provider Name (Legal Business Name): PAUL M DEUS RNFA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 11/24/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
7 MARGO CT
NAPA CA
94558
US
IV. Provider business mailing address
7 MARGO CT
NAPA CA
94558-4537
US
V. Phone/Fax
- Phone: 707-224-7307
- Fax: 707-224-7307
- Phone: 707-224-7307
- Fax: 707-224-7307
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 163W00000X |
| Taxonomy | Registered Nurse |
| License Number | 546758 |
| License Number State | CA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: