Healthcare Provider Details

I. General information

NPI: 1306578661
Provider Name (Legal Business Name): PAUL KUHLMAN CADC 1
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/27/2022
Last Update Date: 06/27/2022
Certification Date: 06/27/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1330 N INDIAN CANYON DR STE A
PALM SPRINGS CA
92262-4880
US

IV. Provider business mailing address

1330 N INDIAN CANYON DR STE A
PALM SPRINGS CA
92262-4880
US

V. Phone/Fax

Practice location:
  • Phone: 760-322-9065
  • Fax:
Mailing address:
  • Phone: 760-322-9065
  • Fax: 760-322-8196

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberCI35470422
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: