Provider Demographics
NPI:1558747162
Name:PAUL OBERON, PSY.D, INC.
Entity Type:Organization
Organization Name:PAUL OBERON, PSY.D, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:OBERON
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:323-937-7777
Mailing Address - Street 1:7421 BEVERLY BLVD.
Mailing Address - Street 2:#10
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90036
Mailing Address - Country:US
Mailing Address - Phone:323-937-7777
Mailing Address - Fax:323-937-2222
Practice Address - Street 1:7421 BEVERLY BLVD.
Practice Address - Street 2:#10
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90036
Practice Address - Country:US
Practice Address - Phone:323-937-7777
Practice Address - Fax:323-937-2222
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-05
Last Update Date:2015-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY14806251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health