1730203050 NPI number — DR. EWA GOSEK M.D.,

Table of content: DR. EWA GOSEK M.D., (NPI 1730203050)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1730203050 NPI number — DR. EWA GOSEK M.D.,

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
GOSEK
Provider First Name:
EWA
Provider Middle Name:
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D.,
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
SZPITEL
Provider Other First Name:
EWA
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
MD
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1730203050
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/07/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 944
Provider Second Line Business Mailing Address:
889 E FRANCIS DR. SUITE A
Provider Business Mailing Address City Name:
PALM SPRINGS
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
92263-0944
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
760-861-0276
Provider Business Mailing Address Fax Number:
760-301-0070

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
889 E FRANCIS DR
Provider Second Line Business Practice Location Address:
SUITE A
Provider Business Practice Location Address City Name:
PALM SPRINGS
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92262-2213
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
760-861-0276
Provider Business Practice Location Address Fax Number:
760-301-0070
Provider Enumeration Date:
03/19/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 2084P0800X , with the licence number:  C050187 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 202316519 , issued by the state of ( MO ) . This identifiers is of the category "MEDICAID".
  • Identifier: C050187 . This is a "MEDICAL LICENCE" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com