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General NPI Number Information
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NPI Number | 1053744870
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Entity Type | Individual
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Provider Name | PAUL PHAM ARAULLO
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Gender | Male
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Dates
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Enumeration Date | 08/15/2013
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Last Update Date | 08/18/2017
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Provider Practice Location Address
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Address Line | 4760 SEPULVEDA BLVD
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City | CULVER CITY
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State | CA
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Zip | 90230-4820
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Country | US
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Telephone | 310-390-6612
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Fax | 310-398-5690
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Provider Business Mailing Address
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Address Line | 121 S LONG BEACH BLVD
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City | COMPTON
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State | CA
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Zip | 90221-3423
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Country | US
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Telephone | 310-627-5850
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Fax | 310-627-5855
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | NPF95002129
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License Number State | CA
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