Organization Active NPI

Paul H Nieberg M D Inc

  • Infectious Disease Physician
  • Pasadena, CA
National Provider Identifier
1396935243
Registry record updated Aug 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infectious Disease PhysicianTaxonomy code 207RI0200X
License
A67350 Issued in CA
Legal business name
PAUL H NIEBERG M D INC
Practice address
960 E Green St Ste 105
Pasadena, CA 91106-2443
Phone
(626) 304-0782
Fax
(626) 658-2848
NPI assigned
Jul 26, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 3, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Paul Henry Nieberg, M.D.NPI 1902909187
Title
President
Phone
(626) 584-1341

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Infectious Disease PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RI0200X A67350 CA Primary

Addresses

Primary practice location

960 E Green St Ste 105
Pasadena, CA 91106-2443

Mailing address

PO Box 1449
Brea, CA 92822-1449
Phone (714) 996-1633

Other identifiers 5

IdentifierTypeStateIssuer
00A673500OtherCABLUE SHIELD OF CALIFORNIA
DB9540OtherCARAILROAD MEDICARE GROUP I
1902909187OtherCAINDIVIDUAL MEDICARE NPI N
00A673500OtherCAMEDI-CAL
P00139012OtherCARAILROAD MEDICARE PROVIDE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040726000716 CA Part B Supplier - Clinic/Group Practice 3678553914 Receives reassigned benefits from 1 practitioner
Practice locations: Pasadena, CA

National Provider Directory

National Provider Directory

Locations

959 E Walnut St
Ste 120
Pasadena, CA 91106
Phone (626) 795-1831

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1185408000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1785715200000",
    "number": "1396935243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1449",
            "city": "BREA",
            "state": "CA",
            "postal_code": "928221449",
            "telephone_number": "714-996-1633",
            "fax_number": "714-996-9267"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "960 E GREEN ST STE 105",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911062443",
            "telephone_number": "626-304-0782",
            "fax_number": "626-658-2848"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAUL H NIEBERG M D INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-26",
        "last_updated": "2026-08-03",
        "certification_date": "2026-08-03",
        "status": "A",
        "authorized_official_last_name": "NIEBERG",
        "authorized_official_first_name": "PAUL",
        "authorized_official_middle_name": "HENRY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "626-584-1341",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "CA",
            "license": "A67350",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD OF CALIFORNIA",
            "identifier": "00A673500",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE GROUP I",
            "identifier": "DB9540",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL MEDICARE NPI N",
            "identifier": "1902909187",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDI-CAL",
            "identifier": "00A673500",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE PROVIDE",
            "identifier": "P00139012",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pasadena, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.