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NPI Code Detail

MEDICARE: ALEX PERKOWSKI

MEDICARE: ALEX PERKOWSKI
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
1390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1780898890
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALEX PERKOWSKI
Provider Business Mailing Address
First Line : 16 LAPIS AVE
Second Line :
City : DANA POINT
State : CA
Zip : 92629-2971
Country : US
Telephone Number : 949-395-1768
Fax Number :
Provider Business Practice Location Address
First Line : 2183 FAIRVIEW RD STE 100
Second Line :
City : COSTA MESA
State : CA
Zip : 92627-5671
Country : US
Telephone Number : 949-515-5440
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/09/2007
Last Update Date : 07/08/2007

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Directions to “ ALEX PERKOWSKI ” Practice Location

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