Provider Demographics
NPI:1861657157
Name:PAULOS, MIERAF
Entity Type:Individual
Prefix:
First Name:MIERAF
Middle Name:
Last Name:PAULOS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:260 GOLDEN GATE AVE
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94102-3706
Mailing Address - Country:US
Mailing Address - Phone:415-292-9930
Mailing Address - Fax:415-292-9951
Practice Address - Street 1:260 GOLDEN GATE AVE
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94102-3706
Practice Address - Country:US
Practice Address - Phone:415-292-9930
Practice Address - Fax:415-292-9951
Is Sole Proprietor?:No
Enumeration Date:2008-07-25
Last Update Date:2008-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator