Healthcare Provider Details

I. General information

NPI: 1801067897
Provider Name (Legal Business Name): BARTOSZ CHMIELOWSKI MD, PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/18/2008
Last Update Date: 02/09/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10945 LE CONTE AVE UCLA, DIVISION OF HEMATOLOGY-ONCOLOGY, PVUB SUITE 2333
LOS ANGELES CA
90095-3000
US

IV. Provider business mailing address

10945 LE CONTE AVE UCLA, DIVISION OF HEMATOLOGY-ONCOLOGY, PVUB SUITE 2333
LOS ANGELES CA
90095-3000
US

V. Phone/Fax

Practice location:
  • Phone: 310-829-5471
  • Fax: 310-829-6192
Mailing address:
  • Phone: 310-206-1214
  • Fax: 310-829-6192

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License NumberA89689
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: