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NPI Code Detail

MEDICARE: TERESA MARIA MOGIELNICKI M.D.

MEDICARE: TERESA MARIA MOGIELNICKI M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine PhysicianA44498CA

General Provider Information

NPI Number : 1043202765
Entity Type Code : Individual
Provider Name (Legal Business Name) : TERESA MARIA MOGIELNICKI M.D.
Provider Business Mailing Address
First Line : 5442 SYCUAN RD
Second Line :
City : EL CAJON
State : CA
Zip : 92019-1816
Country : US
Telephone Number : 619-445-0707
Fax Number : 619-445-0988
Provider Business Practice Location Address
First Line : 5442 SYCUAN RD
Second Line :
City : EL CAJON
State : CA
Zip : 92019-1816
Country : US
Telephone Number : 619-445-0707
Fax Number : 619-445-0988
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/18/2005
Last Update Date : 05/29/2014

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