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NPI Code Detail

MEDICARE: DR. JOANNA JADWIGA PALICA M.D.

MEDICARE: DR. JOANNA JADWIGA PALICA 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
12084P0800XPsychiatry PhysicianA92228CA

General Provider Information

NPI Number : 1144363102
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JOANNA JADWIGA PALICA M.D.
Provider Business Mailing Address
First Line : 8606 MACAWA AVE
Second Line :
City : SAN DIEGO
State : CA
Zip : 92123-2804
Country : US
Telephone Number : 858-627-9964
Fax Number : 858-630-2246
Provider Business Practice Location Address
First Line : 1630 E MAIN ST
Second Line :
City : EL CAJON
State : CA
Zip : 92021-5204
Country : US
Telephone Number : 619-563-5300
Fax Number : 619-590-5155
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/15/2007
Last Update Date : 11/01/2021

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