Healthcare Provider Details

I. General information

NPI: 1932389996
Provider Name (Legal Business Name): PAUL GREGORY BATCHELOR
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/07/2007
Last Update Date: 10/04/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

32261 CAMINO CAPISTRANO D101
SAN JUAN CAPISTRANO CA
92675-3746
US

IV. Provider business mailing address

32261 CAMINO CAPISTRANO D101
SAN JUAN CAPISTRANO CA
92675-3746
US

V. Phone/Fax

Practice location:
  • Phone: 949-429-2155
  • Fax: 949-429-2151
Mailing address:
  • Phone: 949-429-2155
  • Fax: 949-429-2151

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License NumberPT27078B
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: