Healthcare Provider Details

I. General information

NPI: 1225619901
Provider Name (Legal Business Name): ADAM ALEXANDER KOLAWA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/15/2021
Last Update Date: 06/19/2025
Certification Date: 06/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3855 HEALTH SCIENCES DR # 829
LA JOLLA CA
92093-1029
US

IV. Provider business mailing address

3855 HEALTH SCIENCES DR # 829
LA JOLLA CA
92093-1503
US

V. Phone/Fax

Practice location:
  • Phone: 858-657-5281
  • Fax: 858-657-5348
Mailing address:
  • Phone: 858-657-5281
  • Fax: 858-657-5348

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: