Provider Demographics
NPI:1073538278
Name:BELLAMY, PAUL ERIC (MD)
Entity Type:Individual
Prefix:
First Name:PAUL
Middle Name:ERIC
Last Name:BELLAMY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5601 DE SOTO AVE
Mailing Address - Street 2:PULMONARY DEPARTMENT
Mailing Address - City:WOODLAND HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91367-6701
Mailing Address - Country:US
Mailing Address - Phone:818-719-3530
Mailing Address - Fax:818-719-2443
Practice Address - Street 1:5601 DE SOTO AVE
Practice Address - Street 2:PULMONARY DEPARTMENT
Practice Address - City:WOODLAND HILLS
Practice Address - State:CA
Practice Address - Zip Code:91367-6701
Practice Address - Country:US
Practice Address - Phone:818-719-3530
Practice Address - Fax:818-719-2443
Is Sole Proprietor?:No
Enumeration Date:2006-07-12
Last Update Date:2021-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG36684207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G366840OtherMEDICAL PPIN #
CAWG36684BMedicare ID - Type UnspecifiedPPIN #
CAWG36684AMedicare ID - Type UnspecifiedPPIN #
CAA46766Medicare UPIN