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NPI 1083611685

NPI 1083611685 : RYSZARD SKULSKI M.D. : RANCHO MIRAGE, CA

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General NPI Number Information
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    NPI Number           |    1083611685
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    Entity Type          |    Individual 
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    Provider Name        |    RYSZARD SKULSKI M.D.
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    06/28/2005
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    Last Update Date     |    01/17/2022
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Provider Practice Location Address
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    Address Line         |    39000 BOB HOPE DR SUITE K-302
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    City                 |    RANCHO MIRAGE
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    State                |    CA
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    Zip                  |    92270-3221
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    Country              |    US
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    Telephone            |    760-773-0700
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    Fax                  |    760-773-0767
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Provider Business Mailing Address
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    Address Line         |    PO BOX 2011 
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    City                 |    RANCHO MIRAGE
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    State                |    CA
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    Zip                  |    92270-1054
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    Country              |    US
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    Telephone            |    760-773-0700
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    Fax                  |    760-773-0767
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    207RC0000X
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    Taxonomy Name        |    Cardiovascular Disease Physician
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    License Number       |    A77010
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    License Number State |    CA
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