Individual
EUGENE JAMES NOWAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
2440 FENTON STREET, SUITE 101, CHULA VISTA, CA 91914-3516
(619) 420-1840
(619) 420-9630
Mailing address
2440 FENTON ST, SUITE 101, CHULA VISTA, CA 91914-3516
(619) 420-1840
(619) 420-9630
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
20A7103
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00AX71031
—
CA
Enumeration date
11/02/2006
Last updated
12/02/2009
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