Organization
PAUL H. NIEBERG, M.D. INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PAUL HENRY NIEBERG M.D. (PRESIDENT)
(626) 584-1341
Entity
Organization
Contact information
Practice address
960 E GREEN ST STE 105, PASADENA, CA 91106-2443
(626) 304-0782
(626) 658-2848
Mailing address
PO BOX 1449, BREA, CA 92822-1449
(714) 996-1633
(714) 996-9267
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
A67350
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00A673500
BLUE SHIELD OF CALIFORNIA
CA
01
—
1902909187
INDIVIDUAL MEDICARE NPI N
CA
01
—
DB9540
RAILROAD MEDICARE GROUP I
CA
01
—
P00139012
RAILROAD MEDICARE PROVIDE
CA
Enumeration date
07/26/2007
Last updated
10/27/2023
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