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General NPI Number Information
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NPI Number | 1407034481
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Entity Type | Organization
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Legal Business Name | RICHARD P KLIMKOWSKI MD PC
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Dates
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Enumeration Date | 02/01/2008
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Last Update Date | 02/01/2008
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Provider Practice Location Address
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Address Line | 224 DEL MAR #B
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City | SAN CLEMENTE
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State | CA
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Zip | 92672-4011
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Country | US
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Telephone | 949-492-4671
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Fax | 949-492-4330
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Provider Business Mailing Address
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Address Line | 224 DEL MAR #B
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City | SAN CLEMENTE
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State | CA
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Zip | 92672-4011
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Country | US
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Telephone | 949-492-4671
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Fax | 949-492-4330
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Authorized Official
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Title or Position | PRESIDENT
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Name | RICHARD P KLIMKOWSKI
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Credential | MD
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Telephone | 949-492-4671
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207ND0900X
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Taxonomy Name | Dermatopathology Physician
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License Number | G47143
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License Number State | CA
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