Provider Demographics
NPI:1275532301
Name:MAISTROS, PAUL (MD)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:
Last Name:MAISTROS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:PAUL
Other - Middle Name:
Other - Last Name:MAISTROS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 20139
Mailing Address - Street 2:
Mailing Address - City:FOUNTAIN VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92728-0139
Mailing Address - Country:US
Mailing Address - Phone:714-437-1246
Mailing Address - Fax:714-437-1354
Practice Address - Street 1:11160 WARNER AVE
Practice Address - Street 2:SUITE 121
Practice Address - City:FOUNTAIN VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92708-4008
Practice Address - Country:US
Practice Address - Phone:714-437-1246
Practice Address - Fax:714-437-1354
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-20
Last Update Date:2019-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA444962084S0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084S0012XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologySleep Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A444961Medicaid
CAE73331Medicare UPIN
CA00A444961Medicaid