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NPI Code Detail

MEDICARE: BRIAN PIATKOWSKI NP-C

MEDICARE: BRIAN PIATKOWSKI NP-C
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
1363LA2200XAdult Health Nurse Practitioner607081CA

General Provider Information

NPI Number : 1366703233
Entity Type Code : Individual
Provider Name (Legal Business Name) : BRIAN PIATKOWSKI NP-C
Provider Business Mailing Address
First Line : 1020 EDGEMONT ST
Second Line :
City : SAN DIEGO
State : CA
Zip : 92102-2330
Country : US
Telephone Number : 619-884-7513
Fax Number :
Provider Business Practice Location Address
First Line : 200 W ARBOR DR
Second Line : MAIL CODE #8896
City : SAN DIEGO
State : CA
Zip : 92103-9000
Country : US
Telephone Number : 619-543-6200
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/06/2012
Last Update Date : 06/06/2012

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