MEDICARE: DR. PAUL F WHITE MD PHD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207L00000X	Anesthesiology Physician	J3263	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1164537502
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PAUL F WHITE MD PHD

Provider Business Mailing Address
First Line	:	144 ASHBY LN
Second Line	:
City	:	LOS ALTOS
State	:	CA
Zip	:	94022-1615
Country	:	US
Telephone Number	:	650-559-1754
Fax Number	:

Provider Business Practice Location Address
First Line	:	41299 TALLGRASS
Second Line	:
City	:	THE SEA RANCH
State	:	CA
Zip	:	95497-0016
Country	:	US
Telephone Number	:	214-770-3775
Fax Number	:	214-770-3775

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/19/2006
Last Update Date	:	06/10/2013

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