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NPI Code Detail

MEDICARE: BRONEKA KORKAZ

MEDICARE: BRONEKA KORKAZ
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
1363A00000XPhysician AssistantPA67243CA

General Provider Information

NPI Number : 1588483374
Entity Type Code : Individual
Provider Name (Legal Business Name) : BRONEKA KORKAZ
Provider Business Mailing Address
First Line : 4617 VIA BREZZA
Second Line :
City : MODESTO
State : CA
Zip : 95357-0659
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2570 48TH ST
Second Line :
City : SACRAMENTO
State : CA
Zip : 95817-1541
Country : US
Telephone Number : 916-734-2145
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/08/2024
Last Update Date : 12/01/2025

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Directions to “ BRONEKA KORKAZ ” Practice Location

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