Provider Demographics
NPI:1942225362
Name:WRIGHT, PAUL CANDACE (MD)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:CANDACE
Last Name:WRIGHT
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 1:200 WEBSTER ST
Mailing Address - Street 2:100
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94607-4108
Mailing Address - Country:US
Mailing Address - Phone:510-268-3720
Mailing Address - Fax:510-268-0401
Practice Address - Street 1:200 WEBSTER ST
Practice Address - Street 2:100
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94607-4108
Practice Address - Country:US
Practice Address - Phone:510-268-3720
Practice Address - Fax:510-268-0401
Is Sole Proprietor?:No
Enumeration Date:2006-07-13
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG131441207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G131441Medicaid