Provider Demographics
NPI:1013945328
Name:KEY, PAUL HOWARD (MD)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:HOWARD
Last Name:KEY
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 1:5805 WHITE OAK AVE
Mailing Address - Street 2:UNIT #18601
Mailing Address - City:ENCINO
Mailing Address - State:CA
Mailing Address - Zip Code:91416-5128
Mailing Address - Country:US
Mailing Address - Phone:310-836-7414
Mailing Address - Fax:310-836-7485
Practice Address - Street 1:9808 VENICE BLVD
Practice Address - Street 2:SUITE 503
Practice Address - City:CULVER CITY
Practice Address - State:CA
Practice Address - Zip Code:90232-2732
Practice Address - Country:US
Practice Address - Phone:310-836-7414
Practice Address - Fax:310-836-7485
Is Sole Proprietor?:No
Enumeration Date:2006-06-28
Last Update Date:2014-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA26127207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A261270Medicaid
CA00A261270Medicaid
CAA24741Medicare UPIN