Provider Demographics
NPI:1457101602
Name:MAEHLER, PATRICK HENRY
Entity Type:Individual
Prefix:
First Name:PATRICK
Middle Name:HENRY
Last Name:MAEHLER
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 1:520 S INDIAN HILL BLVD APT 206
Mailing Address - Street 2:
Mailing Address - City:CLAREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:91711-5244
Mailing Address - Country:US
Mailing Address - Phone:760-458-7106
Mailing Address - Fax:
Practice Address - Street 1:520 S INDIAN HILL BLVD APT 206
Practice Address - Street 2:
Practice Address - City:CLAREMONT
Practice Address - State:CA
Practice Address - Zip Code:91711-5244
Practice Address - Country:US
Practice Address - Phone:760-458-7106
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-22
Last Update Date:2024-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program