Provider Demographics
NPI:1457340937
Name:SPINKA, PAUL JULIUS (MD)
Entity Type:Individual
Prefix:
First Name:PAUL
Middle Name:JULIUS
Last Name:SPINKA
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 1:1839 SONOMA STREET
Mailing Address - Street 2:
Mailing Address - City:REDDING
Mailing Address - State:CA
Mailing Address - Zip Code:96001
Mailing Address - Country:US
Mailing Address - Phone:530-244-0654
Mailing Address - Fax:530-244-0698
Practice Address - Street 1:1839 SONOMA STREET
Practice Address - Street 2:
Practice Address - City:REDDING
Practice Address - State:CA
Practice Address - Zip Code:96001
Practice Address - Country:US
Practice Address - Phone:530-244-0654
Practice Address - Fax:530-244-0698
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-18
Last Update Date:2008-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG71826207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G718260OtherBLUE SHIELD
CA00G718261Medicaid
CAF67318Medicare UPIN
CA00G718260Medicare PIN