Provider Demographics
NPI:1679758825
Name:STEPHEN PAULUS, DO & BONNIE GINTIS, DO, INC
Entity Type:Organization
Organization Name:STEPHEN PAULUS, DO & BONNIE GINTIS, DO, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT OF CORPORATION
Authorized Official - Prefix:DR
Authorized Official - First Name:BONNIE
Authorized Official - Middle Name:
Authorized Official - Last Name:GINTIS
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:831-688-4201
Mailing Address - Street 1:3233 VALENCIA AVE
Mailing Address - Street 2:SUITE B6
Mailing Address - City:APTOS
Mailing Address - State:CA
Mailing Address - Zip Code:95003-4157
Mailing Address - Country:US
Mailing Address - Phone:831-688-4201
Mailing Address - Fax:831-688-4695
Practice Address - Street 1:3233 VALENCIA AVE
Practice Address - Street 2:SUITE B6
Practice Address - City:APTOS
Practice Address - State:CA
Practice Address - Zip Code:95003-4157
Practice Address - Country:US
Practice Address - Phone:831-688-4201
Practice Address - Fax:831-688-4695
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-07
Last Update Date:2008-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty