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General NPI Number Information
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NPI Number | 1225189418
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Entity Type | Individual
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Provider Name | JOHN J KOWNACKI MD
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Gender | Male
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Dates
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Enumeration Date | 01/15/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 680 FLETCHER PKWY STE 202
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City | EL CAJON
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State | CA
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Zip | 92020-2500
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Country | US
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Telephone | 619-440-2022
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Fax | 619-440-2466
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Provider Business Mailing Address
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Address Line | 13484 CALAIS DR
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City | DEL MAR
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State | CA
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Zip | 92014-3524
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Country | US
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Telephone | 858-794-1505
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Fax |
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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 | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | G84672
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License Number State | CA
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