Organization
PAUL T STALLMAN MD INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PAUL T STALLMAN MD (PRESIDENT)
(805) 481-3733
Entity
Organization
Contact information
Practice address
2 JAMES WAY STE 203, PISMO BEACH, CA 93449-4976
(805) 481-3733
(805) 489-7376
Mailing address
2 JAMES WAY STE 203, PISMO BEACH, CA 93449-4976
(805) 481-3733
(805) 481-7376
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
—
—
207WX0200X
Ophthalmic Plastic and Reconstructive Surgery Physician
Primary
G81743
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ZZZ09560Z
BLUE SHIELD
CA
Enumeration date
11/09/2005
Last updated
03/17/2018
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