Provider Demographics
NPI:1235526021
Name:PAUL, ZACHARY JOHN (MD, MS)
Entity Type:Individual
Prefix:DR
First Name:ZACHARY
Middle Name:JOHN
Last Name:PAUL
Suffix:
Gender:M
Credentials:MD, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:599 INLAND CENTER DR
Mailing Address - Street 2:
Mailing Address - City:SAN BERNARDINO
Mailing Address - State:CA
Mailing Address - Zip Code:92408-1843
Mailing Address - Country:US
Mailing Address - Phone:909-886-2665
Mailing Address - Fax:
Practice Address - Street 1:599 INLAND CENTER DR
Practice Address - Street 2:
Practice Address - City:SAN BERNARDINO
Practice Address - State:CA
Practice Address - Zip Code:92408-1843
Practice Address - Country:US
Practice Address - Phone:909-889-2665
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-04-20
Last Update Date:2019-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA149979208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice