Provider Demographics
NPI:1174610273
Name:DE PAIVA, HELDER (MD)
Entity type:Individual
Prefix:DR
First Name:HELDER
Middle Name:
Last Name:DE PAIVA
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 1:8306 WILSHIRE BLVD # 666
Mailing Address - Street 2:
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90211-2304
Mailing Address - Country:US
Mailing Address - Phone:310-205-2595
Mailing Address - Fax:310-388-5999
Practice Address - Street 1:5901 W OLYMPIC BLVD
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90036-4667
Practice Address - Country:US
Practice Address - Phone:310-205-2595
Practice Address - Fax:310-388-5999
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-09
Last Update Date:2020-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME92869174400000X, 207RN0300X
CAC149852207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL278676100Medicaid
FL1174610273Medicare PIN