Provider Demographics
NPI:1164537502
Name:WHITE, PAUL F (MD PHD)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:F
Last Name:WHITE
Suffix:
Gender:M
Credentials:MD PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:144 ASHBY LN
Mailing Address - Street 2:
Mailing Address - City:LOS ALTOS
Mailing Address - State:CA
Mailing Address - Zip Code:94022-1615
Mailing Address - Country:US
Mailing Address - Phone:650-559-1754
Mailing Address - Fax:
Practice Address - Street 1:41299 TALLGRASS
Practice Address - Street 2:
Practice Address - City:THE SEA RANCH
Practice Address - State:CA
Practice Address - Zip Code:95497-0016
Practice Address - Country:US
Practice Address - Phone:214-770-3775
Practice Address - Fax:214-770-3775
Is Sole Proprietor?:No
Enumeration Date:2006-08-19
Last Update Date:2013-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ3263207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX105910701Medicaid
TX105910701Medicaid
A47344Medicare UPIN