Provider Demographics
NPI:1558602185
Name:HELDER DE PAIVA MD
Entity Type:Organization
Organization Name:HELDER DE PAIVA MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:HELDER
Authorized Official - Middle Name:DE
Authorized Official - Last Name:PAIVA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:310-845-5989
Mailing Address - Street 1:5901 W OLYMPIC BLVD STE 307
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90036-4664
Mailing Address - Country:US
Mailing Address - Phone:310-205-2595
Mailing Address - Fax:310-388-5999
Practice Address - Street 1:5901 W OLYMPIC BLVD STE 307
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90036
Practice Address - Country:US
Practice Address - Phone:310-205-2595
Practice Address - Fax:310-388-5999
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-06
Last Update Date:2019-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME92869207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL278676100Medicaid