| Paul B. Whittemore, Ph.d., A Professional Corporation | |
|
1001 Dove St Suite 145 Newport Beach CA 92660-2838 | |
| (949) 752-7753 | |
| (949) 752-6463 |
| Full Name | Paul B. Whittemore, Ph.d., A Professional Corporation |
|---|---|
| Speciality | Psychologist |
| Location | 1001 Dove St, Newport Beach, California |
| Authorized Official Name and Position | Paul B. Whittemore (LICENSED PSYCHOLOGIST/PRESIDENT) |
| Authorized Official Contact | 9497527753 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Paul B. Whittemore, Ph.d., A Professional Corporation 1001 Dove St Suite 145 Newport Beach CA 92660-2838 Ph: (949) 752-7753 | Paul B. Whittemore, Ph.d., A Professional Corporation 1001 Dove St Suite 145 Newport Beach CA 92660-2838 Ph: (949) 752-7753 |
| NPI Number | 1073887816 |
|---|---|
| Provider Enumeration Date | 02/24/2012 |
| Last Update Date | 02/24/2012 |
| Medicare PECOS PAC ID | 3678731262 |
|---|---|
| Medicare Enrollment ID | O20120229000237 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073887816 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | PSY-11060 (California) | Primary |
| Provider Name | Paul B Whittemore |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1528130010 PECOS PAC ID: 5890953491 Enrollment ID: I20120229000331 |
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