Organization
JOANNA TUKAJ, M.D., INC.
Active
Other names
DR JOANNA'S KIDS MEDICAL CLINIC
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KRZYSZTOF TUKAJ (SECRETARY/BUS.OFC.MGR)
(909) 394-0828
Entity
Organization
Contact information
Practice address
130 W ROUTE 66, STE324, GLENDORA, CA 91740-6252
(626) 914-0017
(626) 914-0288
Mailing address
130 W ROUTE 66, STE324, GLENDORA, CA 91740-6252
(626) 914-0017
(626) 914-0288
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
A051499
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00A514990
MEDI-CAL
CA
01
—
1336407923
TYPE-1 NPI
CA
Enumeration date
08/16/2005
Last updated
06/27/2012
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