Provider Demographics
NPI:1871824672
Name:PAUL J. GETHNER, M.D., INC.
Entity Type:Organization
Organization Name:PAUL J. GETHNER, M.D., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:J
Authorized Official - Last Name:GETHNER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:310-543-2662
Mailing Address - Street 1:21320 HAWTHORNE BLVD
Mailing Address - Street 2:SUITE127
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90503-5606
Mailing Address - Country:US
Mailing Address - Phone:310-543-2662
Mailing Address - Fax:310-540-0812
Practice Address - Street 1:21320 HAWTHORNE BLVD
Practice Address - Street 2:SUITE127
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90503-5606
Practice Address - Country:US
Practice Address - Phone:310-543-2662
Practice Address - Fax:310-540-0812
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-19
Last Update Date:2010-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC12751291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA207N00000XOtherTAXONOMY
CAA30165Medicare UPIN
CACR120AMedicare PIN