Provider Demographics
NPI:1710126131
Name:PAUL B CARLAT, MD, INC.
Entity Type:Organization
Organization Name:PAUL B CARLAT, MD, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:B
Authorized Official - Last Name:CARLAT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:415-563-1155
Mailing Address - Street 1:3329 SACRAMENTO ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94118-1911
Mailing Address - Country:US
Mailing Address - Phone:415-563-1155
Mailing Address - Fax:415-563-2545
Practice Address - Street 1:3329 SACRAMENTO ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94118-1911
Practice Address - Country:US
Practice Address - Phone:415-563-1155
Practice Address - Fax:415-563-2545
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-09
Last Update Date:2017-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA00A1764002084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA20999Medicare UPIN
CA00A176400Medicare PIN