Provider Demographics
NPI:1336596212
Name:AULAKH, J PAUL
Entity Type:Individual
Prefix:
First Name:J PAUL
Middle Name:
Last Name:AULAKH
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2407 KOKANEE WAY
Mailing Address - Street 2:
Mailing Address - City:LEBANON
Mailing Address - State:OR
Mailing Address - Zip Code:97355-3766
Mailing Address - Country:US
Mailing Address - Phone:916-416-9867
Mailing Address - Fax:541-223-5447
Practice Address - Street 1:2407 KOKANEE WAY
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:OR
Practice Address - Zip Code:97355-3766
Practice Address - Country:US
Practice Address - Phone:916-416-9867
Practice Address - Fax:541-223-5447
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-19
Last Update Date:2016-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR2737833344600000X, 347C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes344600000XTransportation ServicesTaxi
No347C00000XTransportation ServicesPrivate Vehicle