Provider Demographics
NPI:1518137975
Name:GLINIECKI, PAUL VICTOR (MD)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:VICTOR
Last Name:GLINIECKI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:1104 N MISSION RD
Mailing Address - Street 2:MEDICAL EXAMINER-CORONER, LOS ANGELES
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90033-1017
Mailing Address - Country:US
Mailing Address - Phone:323-343-0645
Mailing Address - Fax:
Practice Address - Street 1:1104 N MISSION RD
Practice Address - Street 2:MEDICAL EXAMINER-CORONER, LOS ANGELES
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90033-1017
Practice Address - Country:US
Practice Address - Phone:323-343-0645
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-01
Last Update Date:2008-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG74675207ZF0201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZF0201XAllopathic & Osteopathic PhysiciansPathologyForensic Pathology