Provider Demographics
NPI:1861463887
Name:OGDEN, PAUL (MD)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:
Last Name:OGDEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1341 S ELISEO DR
Mailing Address - Street 2:200
Mailing Address - City:GREENBRAE
Mailing Address - State:CA
Mailing Address - Zip Code:94904-2000
Mailing Address - Country:US
Mailing Address - Phone:415-464-8176
Mailing Address - Fax:415-464-8177
Practice Address - Street 1:1341 S ELISEO DR
Practice Address - Street 2:200
Practice Address - City:GREENBRAE
Practice Address - State:CA
Practice Address - Zip Code:94904-2000
Practice Address - Country:US
Practice Address - Phone:415-464-8169
Practice Address - Fax:415-464-8177
Is Sole Proprietor?:No
Enumeration Date:2006-01-28
Last Update Date:2011-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG9824207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA59022Medicare UPIN
CAOOG98240Medicare ID - Type Unspecified