Provider Demographics
NPI:1932374097
Name:PAULUS, SUSAN CARLA
Entity Type:Individual
Prefix:MS
First Name:SUSAN
Middle Name:CARLA
Last Name:PAULUS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:SUSAN
Other - Middle Name:CARLA
Other - Last Name:MEDINA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:HHP
Mailing Address - Street 1:600 CANTOR
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92620-3844
Mailing Address - Country:US
Mailing Address - Phone:949-400-2589
Mailing Address - Fax:
Practice Address - Street 1:600 CANTOR
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92620-3844
Practice Address - Country:US
Practice Address - Phone:949-400-2589
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-29
Last Update Date:2008-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes173C00000XOther Service ProvidersReflexologist