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NPI Code Detail

MEDICARE: PAUL M. JURKOWSKI MD

MEDICARE: PAUL M. JURKOWSKI MD
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 PhysicianG55861CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1396823035
Entity Type Code : Individual
Provider Name (Legal Business Name) : PAUL M. JURKOWSKI MD
Provider Business Mailing Address
First Line : 629 OAKLAND AVE
Second Line :
City : OAKLAND
State : CA
Zip : 94611-4567
Country : US
Telephone Number : 510-658-9480
Fax Number :
Provider Business Practice Location Address
First Line : 629 OAKLAND AVE
Second Line :
City : OAKLAND
State : CA
Zip : 94611-4567
Country : US
Telephone Number : 510-658-9480
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/01/2006
Last Update Date : 11/09/2015

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