MEDICARE: DR. PAUL RONALD BLOCK M.D.

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	207RP1001X	Pulmonary Disease Physician	C33046	CA

General Provider Information

NPI Number	:	1598767550
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PAUL RONALD BLOCK M.D.

Provider Business Mailing Address
First Line	:	227 W JANSS RD
Second Line	:	STE 305
City	:	THOUSAND OAKS
State	:	CA
Zip	:	91360-1848
Country	:	US
Telephone Number	:	805-449-4181
Fax Number	:	805-494-9152

Provider Business Practice Location Address
First Line	:	227 W JANSS RD
Second Line	:	STE 305
City	:	THOUSAND OAKS
State	:	CA
Zip	:	91360-1848
Country	:	US
Telephone Number	:	805-449-4181
Fax Number	:	805-494-9152

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

Provider Enumeration Date	:	06/02/2005
Last Update Date	:	09/07/2007

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