MEDICARE: ROBERT WLODARCZYK, D.O., INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RC0000X	Cardiovascular Disease Physician	20A6483	CA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	ZZZ06304Z	OTHER	CA	MEDICARE PTAN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1134228984
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ROBERT WLODARCZYK, D.O., INC

Provider Business Mailing Address
First Line	:	535 E ROMIE LN
Second Line	:	# 6
City	:	SALINAS
State	:	CA
Zip	:	93901-4026
Country	:	US
Telephone Number	:	831-771-9055
Fax Number	:	831-771-9053

Provider Business Practice Location Address
First Line	:	535 E ROMIE LN
Second Line	:	# 6
City	:	SALINAS
State	:	CA
Zip	:	93901-4026
Country	:	US
Telephone Number	:	831-771-9055
Fax Number	:	831-771-9053

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. ROBERT J WLODARCZYK
Credential	:	D.O.
Telephone Number	:	831-771-9055

Provider Enumeration Date	:	09/21/2006
Last Update Date	:	02/07/2008

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Directions to “ROBERT WLODARCZYK, D.O., INC ” Practice Location

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