Provider Demographics
NPI:1558550053
Name:SCHALCH, PAUL (MD)
Entity type:Individual
Prefix:
First Name:PAUL
Middle Name:
Last Name:SCHALCH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:PAUL
Other - Middle Name:
Other - Last Name:SCHALCH LEPE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:765 MEDICAL CENTER CT STE 210
Mailing Address - Street 2:
Mailing Address - City:CHULA VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:91911-6600
Mailing Address - Country:US
Mailing Address - Phone:619-482-0565
Mailing Address - Fax:619-482-2775
Practice Address - Street 1:765 MEDICAL CENTER CT STE 210
Practice Address - Street 2:
Practice Address - City:CHULA VISTA
Practice Address - State:CA
Practice Address - Zip Code:91911-6600
Practice Address - Country:US
Practice Address - Phone:619-482-0565
Practice Address - Fax:619-482-2775
Is Sole Proprietor?:No
Enumeration Date:2007-10-20
Last Update Date:2023-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA92839207Y00000X, 207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036125120Medicaid
IL036125120Medicaid