Provider Demographics
NPI:1851521603
Name:PAUL R HOLLAND MD INC
Entity Type:Organization
Organization Name:PAUL R HOLLAND 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:REGINALD
Authorized Official - Last Name:HOLLAND
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:434-566-5441
Mailing Address - Street 1:2171 JUNIPERO SERRA BLVD
Mailing Address - Street 2:STE 100
Mailing Address - City:DALY CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94014-1906
Mailing Address - Country:US
Mailing Address - Phone:650-758-2171
Mailing Address - Fax:650-994-0161
Practice Address - Street 1:2171 JUNIPERO SERRA BLVD
Practice Address - Street 2:STE 100
Practice Address - City:DALY CITY
Practice Address - State:CA
Practice Address - Zip Code:94014-1906
Practice Address - Country:US
Practice Address - Phone:650-758-2171
Practice Address - Fax:650-994-0161
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-14
Last Update Date:2010-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA108512207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA6343380001Medicare NSC