Individual
CHRIS A KOSAKOWSKI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1111 SONOMA AVE, STE 112, SANTA ROSA, CA 95405-4813
(707) 579-5520
(707) 579-8820
Mailing address
1111 SONOMA AVE, STE 112, SANTA ROSA, CA 95405-4813
(707) 579-5520
(707) 579-8820
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
G494990
CO
2086S0127X
Trauma Surgery Physician
G494990
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00G494990
BS OF CALIFORNIA
CA
05
—
00G494990
—
CA
01
—
020052144
RAILROAD MEDICARE
CA
Enumeration date
06/27/2006
Last updated
02/01/2021
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