Provider Demographics
NPI:1902898869
Name:AIJIAN, PAUL S (MD)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:S
Last Name:AIJIAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 N LA CUMBRE RD
Mailing Address - Street 2:STE B
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93110-1577
Mailing Address - Country:US
Mailing Address - Phone:805-682-7201
Mailing Address - Fax:
Practice Address - Street 1:200 N LA CUMBRE RD
Practice Address - Street 2:STE B
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93110-1577
Practice Address - Country:US
Practice Address - Phone:805-682-7201
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-17
Last Update Date:2015-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG34375207R00000X, 207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA27-2071738OtherBLUE CROSS SUBMITTER #
CA00G343750OtherBLUE SHIELD PROVIDER ID
CA1902898869Medicaid
CA10939873OtherCAQH
CA1902898869Medicaid
CADM439ZMedicare PIN