# JOHN WITCZAK, DO, PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1043303027
- **Authorized official:** JOHN WITCZAK D.O. (CEO PRESIDENT)
- **Authorized official phone:** (949) 348-2250

## Contact information

- **Practice address:** 26921 CROWN VALLEY PKWY, SUITE 201, MISSION VIEJO, CA 92691-6501
- **Practice address phone:** (949) 348-2250
- **Practice address fax:** (949) 348-8904
- **Mailing address:** 26921 CROWN VALLEY PKWY, SUITE 201, MISSION VIEJO, CA 92691-6501
- **Mailing address phone:** (949) 348-2250
- **Mailing address fax:** (949) 348-8904

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207X00000X | Orthopaedic Surgery Physician | 20A4682 | CA | Yes |

## Other

- **Enumeration date:** 10/02/2006
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 20A4682 | LICENSE | CA |