Paul T Stallman MD Inc

Primary specialty

Ophthalmic Plastic and Reconstructive Surgery PhysicianTaxonomy code 207WX0200X

License

G81743 Issued in CA

Legal business name

PAUL T STALLMAN MD INC

Practice address

2 James Way Ste 203
Pismo Beach, CA 93449-4976

Phone

(805) 481-3733

Fax

(805) 489-7376

NPI assigned

Nov 9, 2005

Organization subpart

No

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

Authorized official

Name

Paul T Stallman, MDNPI 1336120005

Title

President

Phone

(805) 481-3733

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Practitioners 1

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

• Paul T Stallman, MD

  • Ophthalmic Plastic and Reconstructive Surgery Physician
  • Pismo Beach, CA
  • NPI 1336120005
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1131494400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1521244800000",
    "number": "1871574541",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 JAMES WAY STE 203",
            "city": "PISMO BEACH",
            "state": "CA",
            "postal_code": "934494976",
            "telephone_number": "805-481-3733",
            "fax_number": "805-481-7376"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 JAMES WAY STE 203",
            "city": "PISMO BEACH",
            "state": "CA",
            "postal_code": "934494976",
            "telephone_number": "805-481-3733",
            "fax_number": "805-489-7376"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "921 Oak Park Blvd",
            "address_2": "Suite 201B",
            "address_purpose": "LOCATION",
            "city": "Pismo Beach",
            "state": "CA",
            "postal_code": "934493264",
            "country_code": "US",
            "telephone_number": "805-481-3733",
            "fax_number": "805-481-7376",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PAUL T STALLMAN MD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-09",
        "last_updated": "2018-03-17",
        "status": "A",
        "authorized_official_last_name": "STALLMAN",
        "authorized_official_first_name": "PAUL",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "805-481-3733",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207WX0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology, Ophthalmic Plastic and Reconstructive Surgery",
            "state": "CA",
            "license": "G81743",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "ZZZ09560Z",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Pacific Eye Surgeons, a California Professional Medical Corporation
• Rachel Pack
• Natalie Padgett, MD
• Adecia Parker, PT
• Paritosh Patel, DDS
• Irma Del Carmen Perez Martinez, DMD, MS
• Duvy Brian Perez Sanchez
• Perry Patel DDS,Inc
• Andrew Eric Peterson, DC
• Kenneth A Peterson, OD

• Ophthalmic Plastic and Reconstructive Surgery Physician in Pismo Beach, CA
• Providers in Pismo Beach, CA by specialty
• Ophthalmic Plastic and Reconstructive Surgery Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.