Individual
JOHN JAMES KOWALCZYK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
1127 WILSHIRE BLVD, SUITE 805, LOS ANGELES, CA 90017-3901
(213) 977-1176
(213) 977-0668
Mailing address
1127 WILSHIRE BLVD STE 805, LOS ANGELES, CA 90017-3909
(213) 977-1176
(213) 977-0668
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
20A6818
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00AX68180
—
CA
01
—
340018768
MEDICARE RR
—
Enumeration date
09/09/2005
Last updated
11/22/2022
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