Organization
DR. MACIEJ Z. KOWALSKI, O.D. INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MACIEJ KOWALSKI O.D. (OPTOMETRIST/OWNER)
(951) 551-6531
Entity
Organization
Contact information
Practice address
26672 MARGARITA RD, SUITE 305, MURRIETA, CA 92563-2011
(951) 894-1515
(951) 894-1544
Mailing address
28656 BAR HARBOR LN, TEMECULA, CA 92591-2520
(951) 551-6531
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
12596T
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ZZZ63477Y
BLUE SHIELD OF CALIFORNIA
CA
Enumeration date
08/17/2010
Last updated
09/16/2010
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