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General NPI Number Information
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NPI Number | 1356575625
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Entity Type | Organization
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Legal Business Name | ANDRZEJ BULCZYNSKI M.D., INC.
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Dates
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Enumeration Date | 05/14/2009
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Last Update Date | 12/09/2025
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Provider Practice Location Address
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Address Line | 4551 GLENCOE AVE # 145
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City | MARINA DEL REY
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State | CA
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Zip | 90292-6385
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Country | US
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Telephone | 310-574-0383
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Fax | 310-724-8188
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Provider Business Mailing Address
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Address Line | 4551 GLENCOE AVE # 145
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City | MARINA DEL REY
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State | CA
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Zip | 90292-6385
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Country | US
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Telephone | 310-574-0383
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Fax | 310-724-8188
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Authorized Official
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Title or Position | OWNER/PRESIDENT
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Name | DR. ANDRZEJ BULCZYNSKI
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Credential | M.D.
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Telephone | 310-574-0400
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | A89040
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License Number State | CA
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