Provider Demographics
NPI:1881713469
Name:PAULIN, EUGENE H (PSY D)
Entity type:Individual
Prefix:DR
First Name:EUGENE
Middle Name:H
Last Name:PAULIN
Suffix:
Gender:M
Credentials:PSY D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:540 N FAIRVIEW ST
Mailing Address - Street 2:
Mailing Address - City:BURBANK
Mailing Address - State:CA
Mailing Address - Zip Code:91505-3247
Mailing Address - Country:US
Mailing Address - Phone:818-729-0303
Mailing Address - Fax:
Practice Address - Street 1:540 N FAIRVIEW ST
Practice Address - Street 2:
Practice Address - City:BURBANK
Practice Address - State:CA
Practice Address - Zip Code:91505-3247
Practice Address - Country:US
Practice Address - Phone:818-729-0303
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-28
Last Update Date:2007-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20403103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1881713469OtherMEDICARE NPI