Provider Demographics
NPI:1790246700
Name:KAISER, PAULINA (MD)
Entity Type:Individual
Prefix:DR
First Name:PAULINA
Middle Name:
Last Name:KAISER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:240 RENAISSANCE PKWY NE APT 103
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30308-2349
Mailing Address - Country:US
Mailing Address - Phone:408-515-2102
Mailing Address - Fax:
Practice Address - Street 1:519 MEMORIAL DR SE UNIT B10
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30312-2289
Practice Address - Country:US
Practice Address - Phone:404-919-0530
Practice Address - Fax:734-270-4523
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-31
Last Update Date:2023-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
GA879842084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program