Provider Demographics
NPI:1760542930
Name:MARGRAF, PAUL SCOTT (PA-C)
Entity Type:Individual
Prefix:MR
First Name:PAUL
Middle Name:SCOTT
Last Name:MARGRAF
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10240 MONTEREY STREET
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90805
Mailing Address - Country:US
Mailing Address - Phone:562-424-4404
Mailing Address - Fax:
Practice Address - Street 1:2880 ATLANTIC AVE STE 230
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90806-1735
Practice Address - Country:US
Practice Address - Phone:562-424-4404
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-11
Last Update Date:2014-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CACA15178363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical