Healthcare Provider Details

I. General information

NPI: 1497617898
Provider Name (Legal Business Name): KATARZYNA GRZEGORCZYK L.AC.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/25/2025
Last Update Date: 11/25/2025
Certification Date: 11/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11915 W WASHINGTON BLVD
LOS ANGELES CA
90066-5815
US

IV. Provider business mailing address

11131 ROSE AVE APT 15
LOS ANGELES CA
90034-6067
US

V. Phone/Fax

Practice location:
  • Phone: 310-572-1515
  • Fax:
Mailing address:
  • Phone: 818-642-6281
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number11504
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: