Provider Demographics
NPI:1164082400
Name:SHERPAUL CORPORATION
Entity Type:Organization
Organization Name:SHERPAUL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:DZIUBAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:951-696-2100
Mailing Address - Street 1:901 HACIENDA DR STE B
Mailing Address - Street 2:
Mailing Address - City:VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:92081-6498
Mailing Address - Country:US
Mailing Address - Phone:760-639-6472
Mailing Address - Fax:760-639-6473
Practice Address - Street 1:41880 KALMIA ST STE 140
Practice Address - Street 2:
Practice Address - City:MURRIETA
Practice Address - State:CA
Practice Address - Zip Code:92562-8837
Practice Address - Country:US
Practice Address - Phone:951-696-2100
Practice Address - Fax:951-696-2122
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-18
Last Update Date:2019-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care