Provider Demographics
NPI:1457370751
Name:REMIS, PAUL M (MD)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:M
Last Name:REMIS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:PAUL
Other - Middle Name:M
Other - Last Name:REMIS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:1521 HIGUERA ST
Mailing Address - Street 2:SUITE F
Mailing Address - City:SAN LUIS OBISPO
Mailing Address - State:CA
Mailing Address - Zip Code:93401-2958
Mailing Address - Country:US
Mailing Address - Phone:805-544-1521
Mailing Address - Fax:805-544-1520
Practice Address - Street 1:1521 HIGUERA ST
Practice Address - Street 2:SUITE F
Practice Address - City:SAN LUIS OBISPO
Practice Address - State:CA
Practice Address - Zip Code:93401-2958
Practice Address - Country:US
Practice Address - Phone:805-544-1521
Practice Address - Fax:805-544-1520
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA241232084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA82944Medicare UPIN