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Individual

DR. THEODORE KACZMAR JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
220 SAN JOSE ST, SALINAS, CA 93901-3901
(831) 424-0807
(831) 424-3408
Mailing address
1033 LOS PALOS DR, SALINAS, CA 93901-3916
(831) 757-2058
(831) 757-0232

Taxonomy

Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
G546380
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
94170316793901A002
TRICARE
05
ZZZ70373Z
CA
Enumeration date
08/02/2006
Last updated
05/01/2019
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