Provider Demographics
NPI:1912909037
Name:EPHRAIM, PAUL D (MD)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:D
Last Name:EPHRAIM
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Gender:M
Credentials:MD
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Mailing Address - Street 1:8510 BALBOA BLVD
Mailing Address - Street 2:SUITE 150
Mailing Address - City:NORTHRIDGE
Mailing Address - State:CA
Mailing Address - Zip Code:91325-5810
Mailing Address - Country:US
Mailing Address - Phone:818-637-2000
Mailing Address - Fax:818-654-3417
Practice Address - Street 1:2601 W ALAMEDA AVE
Practice Address - Street 2:STE 100
Practice Address - City:BURBANK
Practice Address - State:CA
Practice Address - Zip Code:91505-4808
Practice Address - Country:US
Practice Address - Phone:818-295-6944
Practice Address - Fax:818-295-6948
Is Sole Proprietor?:No
Enumeration Date:2005-06-01
Last Update Date:2015-08-31
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Provider Licenses
StateLicense IDTaxonomies
CAG14895207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G148950Medicaid
CAWG14895AMedicare PIN
CAV39274Medicare UPIN