1053518928 NPI number — DR. PAULA BINA FIRESTONE PH.D.

Table of content: DR. PAULA BINA FIRESTONE PH.D. (NPI 1053518928)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1053518928 NPI number — DR. PAULA BINA FIRESTONE PH.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
FIRESTONE
Provider First Name:
PAULA
Provider Middle Name:
BINA
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
PH.D.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
SPIRO
Provider Other First Name:
PAULA
Provider Other Middle Name:
FIRESTONE
Provider Other Name Prefix Text:
MRS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1053518928
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
11525 BROOKSHIRE AVE
Provider Second Line Business Mailing Address:
SUITE 401
Provider Business Mailing Address City Name:
DOWNEY
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
90241-4985
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
562-904-7660
Provider Business Mailing Address Fax Number:
562-904-7693

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
11525 BROOKSHIRE AVE
Provider Second Line Business Practice Location Address:
SUITE 401
Provider Business Practice Location Address City Name:
DOWNEY
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90241-4985
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
562-904-7660
Provider Business Practice Location Address Fax Number:
562-904-7693
Provider Enumeration Date:
07/02/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 103T00000X , with the licence number:  PSY7580 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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