Provider Demographics
NPI:1477511178
Name:PAUDA, JOSE MARIO (MD)
Entity Type:Individual
Prefix:
First Name:JOSE
Middle Name:MARIO
Last Name:PAUDA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:631 E ALVIN DR
Mailing Address - Street 2:
Mailing Address - City:SALINAS
Mailing Address - State:CA
Mailing Address - Zip Code:93906-3056
Mailing Address - Country:US
Mailing Address - Phone:831-444-6200
Mailing Address - Fax:831-444-6222
Practice Address - Street 1:631 E ALVIN DR
Practice Address - Street 2:
Practice Address - City:SALINAS
Practice Address - State:CA
Practice Address - Zip Code:93906-3056
Practice Address - Country:US
Practice Address - Phone:831-444-6200
Practice Address - Fax:831-444-6222
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-02
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA75654174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAH93899Medicare UPIN