Provider Demographics
NPI:1033120720
Name:COBURN, PAUL CHRISTOPHER (PHD)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:CHRISTOPHER
Last Name:COBURN
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:713 W WALDHEIM RD
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15215-1807
Mailing Address - Country:US
Mailing Address - Phone:412-782-2966
Mailing Address - Fax:412-968-0527
Practice Address - Street 1:1326 FREEPORT RD
Practice Address - Street 2:SUITE 250
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15238-3131
Practice Address - Country:US
Practice Address - Phone:412-967-5656
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS00418-L103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical