Provider Demographics
NPI:1255507489
Name:PAUL, ROWAN VICTOR (M D)
Entity Type:Individual
Prefix:DR
First Name:ROWAN
Middle Name:VICTOR
Last Name:PAUL
Suffix:
Gender:M
Credentials:M D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2248 PARK BLVD
Mailing Address - Street 2:
Mailing Address - City:PALO ALTO
Mailing Address - State:CA
Mailing Address - Zip Code:94306-1532
Mailing Address - Country:US
Mailing Address - Phone:650-328-4411
Mailing Address - Fax:
Practice Address - Street 1:2100 WEBSTER ST STE 416
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94115-2379
Practice Address - Country:US
Practice Address - Phone:650-328-4411
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-07
Last Update Date:2022-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA99977207QS0010X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QS0010XAllopathic & Osteopathic PhysiciansFamily MedicineSports Medicine