Provider Demographics
NPI:1861449738
Name:PAEZ, PAUL A (DC)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:A
Last Name:PAEZ
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:276 N EL CAMINO REAL
Mailing Address - Street 2:SUITE C
Mailing Address - City:ENCINITAS
Mailing Address - State:CA
Mailing Address - Zip Code:92024-2860
Mailing Address - Country:US
Mailing Address - Phone:706-632-1134
Mailing Address - Fax:760-632-9956
Practice Address - Street 1:276 N EL CAMINO REAL
Practice Address - Street 2:SUITE C
Practice Address - City:ENCINITAS
Practice Address - State:CA
Practice Address - Zip Code:92024-2860
Practice Address - Country:US
Practice Address - Phone:706-632-1134
Practice Address - Fax:760-632-9956
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC0278350111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC0278350OtherSTATE LICENSE