Healthcare Provider Details

I. General information

NPI: 1578723151
Provider Name (Legal Business Name): JOSEPH WILLIAM DOMBROWSKY M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/17/2008
Last Update Date: 07/06/2022
Certification Date: 05/14/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5471 KEARNY VILLA RD STE 202
SAN DIEGO CA
92123-1141
US

IV. Provider business mailing address

910K E REDD RD STE 506
EL PASO TX
79912-7324
US

V. Phone/Fax

Practice location:
  • Phone: 619-299-6299
  • Fax:
Mailing address:
  • Phone: 301-646-2994
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number0116020672
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code207QS1201X
TaxonomySleep Medicine (Family Medicine) Physician
License Number0101246854
License Number StateVA
# 3
Primary TaxonomyY
Taxonomy Code207QS1201X
TaxonomySleep Medicine (Family Medicine) Physician
License NumberC172392
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: